skip to main content

Serum urate normal during flare — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

EasyMusculoskeletal InvestigationsSerum urate normal during flareSCE Rheumatology

A 58-year-old man has acute podagra with normal serum urate during the flare and aspiration is feasible. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: BGout

Gout is the single best answer because serum urate can be normal during an acute gout flare. The stem is testing diagnostic synthesis, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Rheumatoid arthritis is less suitable because it fits a different clinical pattern or a different treatment threshold; Systemic lupus erythematosus, Psoriatic arthritis and Calcium pyrophosphate crystal arthritis do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: BSR hot swollen joint guidance; EULAR imaging/autoantibody recommendations