Inability To Bear Weight in Medicine / Internal Medicine — 55yo Man | Rheumatology | SMLE Q#17608

SMLE Question #17608

Medicine / Internal Medicine Rheumatology

Objective: OBJ-IM-RHEUM-CRYSTALS-001

Last updated: February 2026
A 55-year-old man develops sudden severe pain, swelling, and erythema of the right first metatarsophalangeal joint overnight with inability to bear weight. He has hypertension treated with a thiazide diuretic and drinks alcohol on weekends. Arthrocentesis yields cloudy synovial fluid, and crystal analysis under polarized light microscopy is performed. Which of the following describes the characteristic appearance of monosodium urate crystals?

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