MSFinals-2773

A 55-year-old man presents with significant pain in the right first metatarsophalangeal joint that started quickly overnight. He has tried taking paracetamol but this failed to reduce the pain sufficiently. On closer inspection, there appears to be much effusion around the joint, which is also tender to palpation. The patient is at the end of his third month of being treated for tuberculosis.

The patient’s pulse is 89 bpm, respiratory rate is 14/min, temperature is 37.1oC, and blood pressure is 130/82 mmHg. A joint aspirate sample is taken.

What is the likely result of inspecting the joint aspirate?