Medical history A 57-year-old hypertensive male patient, who works as a salesman, describes himself as a light drinker and is moderate overweight (grade 1 obesity), seeks medical attention. He complains of sudden pain, flogosis and swelling in his left elbow and in his second and fifth right proximal interphalangeal joints. On examination, he is in good general condition and presents with signs of acute inflammation, severe pain on motion and limited range of movement in the referred articulations. He reports that he had a similar acute episode two months ago, which lasted for five days and ameliorated with the use of NSAIDs. Figure 1: Radiographs os the left and right hands, respectivelyFigure 2: Radiographs of the left and right elbows, respectively Question:Taking the images and the clinical history into consideration, which is the most likely diagnosis? Tophaceous gout Osteoarthritis Reactive arthritis Rheumatoid arthritis Time is Up! Time's up
