Cholesterol and Monosodium Urate Crystals in Synovial Fluid from a Patient with Gout

AbstractA 66 years old Caucasian male presented with left elbow pain and swelling of 1 week duration. He denied any preceding trauma or fevers. He had a past history of diabetes mellitus, hypertension, hyperlipidemia and chronic kidney disease. 5 years ago, he was diagnosed with gout when he had podagra, which was treated with indomethacin. He did not take any urate ‐lowering medication. He reported multiple episodes of gout every year, mostly in the feet. On exam, he had swelling, tenderness, warmth, erythema and decreased range of motion of the left elbow. Synovial fluid aspiration was performed, and revealed monosodium urate crystals and cholesterol crysta ls (Figure 1, Figure 2). Gram stain and bacterial cultures were negative. He was treated with 5 days course of oral corticosteroids and the symptoms resolved after which, he was started on urate lowering therapy.

Source: Arthritis and Rheumatology - June 9, 2020 Category: Rheumatology Authors: Pankaj Bansal, Andrew R. Virata Tags: CLINICAL IMAGE Source Type: research