First Metatarsophalangeal
Also written as MTP.
A 48-year-old man is experiencing marked pain in his left first metatarsophalangeal joint.
What our notes say
- A 48-year-old man is experiencing marked pain in his left first metatarsophalangeal joint. (Immunopathology complete mcqs — Past Paper Questions & Answers)
- | Joint distribution | First metatarsophalangeal (MTP) joint (podagra) most common; also ankles, knees, elbows, wrists, fingers, and the ear helix. | Lower temperature in distal joints favors crystal precipitation; mechanical stress and reduced blood flow promote nucleation. | (Gout and crystal arthropathies)
- A 48‑year‑old male farmer presents with a 2‑day history of sudden, excruciating pain in the right first metatarsophalangeal (MTP) joint. (Gout and crystal arthropathies)
- A 55-year-old obese man develops sudden onset of severe pain, redness and swelling of the first metatarsophalangeal joint. (Master Bone & Soft Tissue Pathology: CAT 2 MCQs & Answers)
Practice questions on First Metatarsophalangeal
A 48-year-old man has severe pain, swelling, and tenderness in his left first metatarsophalangeal joint. Joint aspiration shows neutrophils and needle-shaped crystals. His acute response is most likely mediated through crystal-induced NOD-like receptor signaling of which of the following?
- Antigen-antibody complex
- Complement membrane attack complex
- Inflammasome
- Mast cell
Answer: C. Needle-shaped (sodium urate) crystals in the joint = acute gout. Crystals activate NOD-like receptors → inflammasome assembly → caspase-1 activation → cleavage of pro-IL-1β to active IL-1β → acute inflammatory arthritis.