KROK 1 2015 – Question 190 · KROK (Medicine) · Pathomorphology
A 49-year-old man complains of pain in his metatarsophalangeal joints and joint deformation. In blood hyperuricemy can be observed. X-ray has revealed metatarsophalangeal joint space narrowing, erosion, periarticular calcification of the both joints, osteoporosis. Microscopy has revealed inflammatory granulomatous reaction surrounding necrotizing masses in the area of the first metatarsophalangeal joint. Choose the most likely diagnosis:
- A. Gout (podagra)
- B. Urolithiasis
- C. Rheumatoid arthritis
- D. Pyrophosphate arthropathy
- E. Hyperparathyroidism
Hint
Link the laboratory finding with the microscopic picture of necrotic masses ringed by granulomatous inflammation and ask which substance is being deposited around the joint.
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