Question

All of the following statements about primary gout arthritis are true, except:

• A. 90% of cases are caused by over production of uric acid
• B. Uric acid levels may be normal at the time of an acute attack
• C. Men are more commonly affected than women
• D. Definitive diagnosis requires aspiration of synovial fluid

Hint:

In primary gout most patients are under-excretors, not over-producers.

Answer 1

The Correct Option is A

Step 1: Gout is a disorder of urate metabolism where monosodium urate crystals deposit in joints. The question asks which statement is FALSE.

Step 2: In primary gout, the cause is hyperuricemia. The key fact is the split between two mechanisms. About 90% of patients are urate under-excretors (the kidney clears too little uric acid). Only about 10% are over-producers. So option A reverses the real figures and is the false statement.

Step 3: Why the others are true. During an acute attack serum uric acid can be normal or even low, because urate shifts into the joint and acute phase changes lower the blood level, so a normal value never rules out gout (B is true). Gout is far more common in men, since estrogen is uricosuric and protects women until menopause (C is true). The definitive, gold-standard diagnosis is finding negatively birefringent needle-shaped urate crystals in aspirated synovial fluid under polarised light (D is true).

Step 4: Therefore the untrue statement is the claim that 90% of cases come from over production.

Correct option: A.