A 25-year-old male presents to the emergency department after falling on an outstretched hand while skateboarding. He reports pain and swelling in the wrist, particularly over the radial side. Physical examination reveals tenderness in the anatomical snuffbox. Initial X-rays are unremarkable. Which of the following is the most concerning complication of this patient’s injury?

A 62-year-old female with a 10-year history of gout presents with hard, painless nodules on her fingers and elbows. She reports occasional joint stiffness but no acute pain currently. Imaging reveals joint erosions near the nodules. What is the most likely composition of the nodules (tophi) observed in this patient with chronic gout?

A 70-year-old male with a long-standing history of untreated gout presents with firm, nodular deposits on his elbows, fingers, and ears. He also reports chronic joint pain and stiffness. X-ray of the affected joints shows erosions with overhanging edges. Which of the following best describes the pathogenesis of tophi formation and joint destruction in chronic gout?

Patient Case: A 48-year-old male with an acute gout flare in his right ankle is started on treatment. His symptoms resolve within 12 days without further intervention. Laboratory tests during the flare showed elevated interleukin-1 beta (IL-1β) levels. Question: Which mechanism most likely contributed to the spontaneous resolution of this patient’s acute gout flare?

A 62-year-old male with poorly controlled diabetes and a history of recurrent gout attacks presents with a self-resolving episode of joint pain in his left knee. He reports that his symptoms usually improve in 10–14 days without medication. Laboratory tests show hyperuricemia, but synovial fluid analysis is negative for bacterial infection. Which of the following mechanisms contributes to the spontaneous resolution of gout flares?

A 55-year-old male presents to the emergency department with severe pain, redness, and swelling in his right big toe that started suddenly overnight. He has a history of hypertension and admits to consuming alcohol frequently. His serum uric acid level is 9.2 mg/dL (normal range: 3.4–7.0 mg/dL). What is the primary mechanism by which monosodium urate (MSU) crystals initiate inflammation in this patient’s acute gout flare?

A 55-year-old male with a history of hypertension, obesity, and chronic kidney disease presents with sudden-onset severe pain, redness, and swelling in his right first metatarsophalangeal (MTP) joint. He states that the pain started overnight and is excruciating. Joint aspiration reveals negatively birefringent needle-shaped crystals under polarized light microscopy. Which of the following is the primary inflammatory mediator responsible for the acute gout flare in this patient?

A 14-year-old boy with Osgood-Schlatter disease is eager to return to playing soccer. He asks the physician how long it will take for his symptoms to resolve. Which of the following statements is the most appropriate response?

A 14-year-old female basketball player reports pain below her knee for 6 weeks, worse after games. She denies trauma but notes a tender bump at the tibial tuberosity. Her coach asks about treatment. Physical exam confirms pain with resisted knee extension and a prominent tibial tuberosity. She has no fever or systemic symptoms. Question: What is the most appropriate initial management for this patient’s condition?

A 12-year-old basketball player complains of pain below the knee that worsens with jumping and running. Examination shows localized swelling and tenderness over the tibial tubercle without joint effusion. Which of the following is the best initial management?