Plate · GoutAnterior view

Close-up

Gout

Monosodium urate crystals

The figure showsLook at the face, hands and feet

Memory hook

Sudden, exquisite pain in the big toe at night, in a man after a feast or alcohol.

Exam clue

Needle-shaped, negatively birefringent crystals in joint fluid. Never start or stop allopurinol during an acute attack.

In India

Rising with richer diets, alcohol and metabolic syndrome.

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