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What is True about gout is - and explain in detail?
(A) (most common joint involved in first metatarsaphalangeal of big toe) (1097 - Davidson 21st) (77-80 Apley 9th).GOUTTrue crystal deposition disease, presence of monosodium urate monohydrate (MSU) crystals, especially the firstMTP joint and small joints of feet and hands.* Bursitis - commonly of the olecranon bursaCrystal associated arthritis and deposition in connective tissueCrystalAssociation* Monosodium urate monohydrate* Acute gout* Chronic tophaceous gout* Calcium pyrophosphate dehydrateAcute "pseudo gout"Chronic (pyrophosphate / arthropathy)Chondrocalcinosis* Basic calcium phosphatesCalcific periarthritis calcinosis* Cholesterol* Chronic effusion in RA* Calcium oxalate* Acute arthritis in dialysis patientsConfirmation of diagnosis - negatively birefringent urate crystals in the synovial fluids**** Hyperuricaemia is not "diagnostic" and is often seen in normal middle aged men**** X-ray acute attack shows only soft tissue swelling chronic: - Joint space narrowing, secondary osteoarthritis.* Tophi appears as characteristics punched out "cyst" or deep erosions in para-articular bone ends.* Bone destruction is more marked (may resemble neoplastic disease).GOUTPSEUDOGOUT* Smaller joint* Large joint* Pain intense* Pain moderate* Joint inflamed* Joint swollen* Hyperuricaemia* Chondrocalcenosis* Uric acid crystals* Calcium pyrophosphate crystals * Meniscus calcification may be seen on X-ray knee joint.