Case 315

Medical history

Male, 72 years-old, with hypertension and chronic alcoholism (1,5 liters of beer a day), relates pain and an ulcerated lesion with a white content in the fourth right finger, with four months of evolution. He complains pain at rest and with movement of the finger, associated with a burning sensation. At the physical exam, it is noted a severe deformity in this finger, an articular swelling and presence of tophi, with hyperemia and local increased temperature. He shows a recent radiography of his hands and wrists.

Image 1: Hands and wrists radiograph, posteroanterior incidence.

With the clinical case and the radiography showed, which is the most likely diagnosis?

Test question

(PSU-MG 2016, Direct Acess) Male, 42 years old, previously healthy, presents with nocturnal pain in left metatarsophalangeal joint of sudden onset, of high intensity and after increased alcohol intake (beer). At physical examination, he is afebrile and there are obvious signs of arthritis in the joint. 

Among the statements listed below, check the INCORRECT answer:

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