Long-standing Plaque Psoriasis in Medicine / Internal Medicine — 40yo Man | Rheumatology | SMLE Q#12050
SMLE Question #12050
Medicine / Internal Medicine
Rheumatology
Objective: OBJ-383
Last updated: February 2026
A 40-year-old man with long-standing plaque psoriasis and nail pitting has gout treated with allopurinol. For 4 months, he has recurrent joint pain with morning stiffness lasting about 60 minutes involving the right first MTP, left ankle, and both knees. Examination shows a warm, swollen, tender left ankle and both knees with limited range of motion. Knee arthrocentesis shows inflammatory synovial fluid, and polarized microscopy shows no crystals. Which of the following is the most likely cause of his current joint pain?
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