Urate Crystals in Asymptomatic Metatarsophalangeal Joints

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Precipitation of monosodium urate crystals within the joint appears to be a prerequisite for the development of acute gouty arthritis (1). These crystals can be found in the synovial fluid of patients with acute or chronic gouty arthritis. Further, urate crystals have been found in biopsies (2) or in aspirated fluids of asymptomatic but previously involved joints (AGUDELO CA, WEINBERGER A, SCHUMACHER HR, TURNER R, MOLINA J. Unpublished observations.). Agudelo and Schumacher (3) have found synovial microtophi during first attacks of gout. Whether urate crystals can also be detected in the synovial fluid of asymptomatic joints not previously affected in

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