This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Crystal Ahropathy, Subject name: Medicine
All joints are involved in acute gout except: 
Select and explain. 
A. MTP, B. Gleno-humeral joint, C. Ankle joint, D. Knee joint
B: Gleno-humeral joint
Answer: B: Gleno-humeral joint 
Explanation: Other than the great toe, the most common sites of gouty ahritis are the ankle, wrist, finger joints, and knee. In early gout, only 1 or 2 joints are usually involved. Consider the diagnosis in any patient with acute monoaicular ahritis of any peripheral joint except the glenohumeral joint of the shoulder.