<prompt> A 53-year-old man has a slowly enlarging bump over the olecranon process of his elbow. The mass is excised and on section has a chalky white consistency. Microscopically, the mass is composed of elongated, needle-shaped crystals that under polarized light are negatively birefringent. Surrounding the crystals is a granulomatous inflammatory infiltrate. True statements concerning his condition include all of the following, except?Most patients with hyperuricemia will develop itThe first metatarsal-phalangeal joint is usually involvedThe crystals can also be seen in synol fluidThis lesion can erode bone and cailage  <response>: Most patients with an increased serum uric acid do not have a gouty ahritis, though some do. Gouty tophi can develop in gout. 