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 Best of Five 196

 

   

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BOF: 196

A 54-year-old male wakes up with excruciating pain in his right big toe. On examination he has swelling of the metacarpophalangeal joint of his right hallux with overlying erythema. It is tender to touch and the patient is febrile. Initial investigations reveal a raised white cell, count and an elevated ESR.

In this patient:

a)      A high serum uric acid is the most specific and diagnostic test

b)      Joint fluid aspirate for culture is the most specific and diagnostic test

c)      Joint fluid aspirate for microscopy is the most specific and diagnostic test

d)      Demonstration of periarticular deposits on X-ray, giving a halo of radio-opacity is the most specific and diagnostic test

e)      Demonstration of clearly defined (“punched out”) bone cysts on X-ray is the most specific and diagnostic test

 

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