May I add a patient seen recently who presented with 3 months of markedly inflammatory polyarthritis- of which all joints/bursae aspirated revealed large quantities of typical Uric acid crystals. Atypical as gout tends to be self limiting and even as Uric acid was brought below 5 mg/dl he barely improved while coincidentally on moderate doses of medrol and colchicine. "Something was wrong in Dodge". Lab work done monthly over 4 months ( CBC, CMP, UA ). The 4th draw revealed the acute leukemia that was driving the gout. Yet WBC never above 10 and smears always normal until the last! His case drives home the diagnostic approach that if it doesn't make sense, keep looking!