Question: Question linked to image nº8 A 75-year-old patient with a history of hypertension and hyperuricemia. In treatment with ACE inhibitors and allopurinol 100 mg daily. He went to the emergency room for a picture of several days of evolution of inflammatory rhythm pain in the small joints of the hands of progressive course together with daily fever of up to 37.8ºC. It has raised yellowish lesions on the skin around the interphalangeal and metatarsophalangeal joints that in recent days have left a yellowish liquid through the skin. On examination, it presents inflammatory signs at the proximal and distal interphalangeal levels of both hands. A simple x-ray of both hands is performed (see image). Which of the following statements is true in relation to the diagnosis of this patient? 
 Options:  <1> The drainage of yellowish whitish material through the skin is synonymous with infection and requires the initiation of antibiotic treatment immediately. <2> If the analysis of the synovial fluid showed a cell count between 2000 and 60,000 / μl, it would be a septic polyarthritis and specific treatment should be started immediately. <3> To establish the diagnosis of tophaceous gout, it is essential that uric acid levels are well above the reference range in all determinations. <4> To confirm the diagnosis, a complete study of the fluid is recommended. <5> The diagnostic technique of choice is arthroscopy.
4