<prompt> This elderly male came with a history of recurrent attacks of pain and swelling in the great toe in the past. This is the present x-ray of the hands. The diagnosis can be confirmed byAnti CCP antibodiesPolarised microscopy of tissue fluid aspirateXray of lumbosacral spineHLA B27  <response>: Radiological features in GoutSoft tissue findingsCalcific deposits in gouty tophi in 50 only calcium urate crystals are opaqueEccentric juxta-aicular lobulated soft-tissue masses hand, foot, ankle, elbow, kneeBilateral olecranon bursitisAural calcificationJoint findingsPreservation of joint space initiallyAbsence of periaicular demineralizationErosion of joint margins with sclerosisCailage destruction late in course of diseasePeriaicular swelling in acute monaicular goutChondrocalcinosis menisci, aicular cailage of knee resulting in secondary osteoahritisBone findingsPunched-out lytic bone lesion - sclerosis of marginMouse rat bite from erosion of long-standing soft-tissue tophusOverhanging margin 40Ischemic necrosis of femoralhumeral headsBone infarctionDiagnosis of gout relies on the identification of MSU crystals under a compensated polarized light microscope CPLM in synol fluid aspirated from the patients joint. 