Sudden-onset Severe Pain in Medicine / Internal Medicine — 30yo Man | Rheumatology | SMLE Q#11268
SMLE Question #11268
Medicine / Internal Medicine
Rheumatology
Objective: OBJ-383
Last updated: February 2026
A 30-year-old man presents to the Emergency Department with sudden-onset severe pain, redness, and swelling of the right first metatarsophalangeal joint that began overnight. He cannot bear weight. He drinks alcohol regularly and recently started a thiazide diuretic for hypertension. Arthrocentesis shows inflammatory synovial fluid with crystals on polarized light microscopy. Which of the following best describes the characteristic appearance of the crystals in this condition?
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