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A 46-years-old male presents to the emergency department with severe right toe pain. The patient was in usual state of health until early in the morning when he woke up with severe pain in his right big toe. The patient denies any trauma to the toe and no previous history of such pain in other joints. He mentioned that he had a "few too many" beers and BBQ meat with the guy's last night. On examination, he was found to have a temperature of 38.2°C and in moderate distress secondary to the pain in his right toe. The right big toe was swollen, warm, red, and exquisitely tender. The remainder of the exam was normal. Synovial fluid was obtained and revealed rod- or needle-shaped crystals.
1. What is likely the diagnosis for his condition? What diagnostic tests would you use to make a definitive diagnosis?
2. What are the underlying causes of this condition?
3. What first line treatment options are available for this patient?
4. State two similarities between gout and Rheumatoid arthritis.
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