skip to main content

Gout — MCCQE Part 1 MCQ

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

ModerateJoint PainGoutMCCQE Part 1

A 54-year-old man develops sudden severe pain, erythema, and swelling at the first metatarsophalangeal joint overnight after a seafood meal. He is afebrile, and joint aspiration shows needle-shaped negatively birefringent crystals. What is the most likely diagnosis?

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

Reveal the answer and explanation

Correct answer: A — Gout

Acute podagra with needle-shaped negatively birefringent crystals is gout. Pseudogout has positively birefringent rhomboid calcium pyrophosphate crystals and often affects knees or wrists. Septic arthritis remains important if fever or organisms are present, but the crystal description is diagnostic. Rheumatoid arthritis is usually chronic and symmetric.

Reference: Canadian Rheumatology Association gout guidance