This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
Tophi in gout found in all regions except -a)  Joint capsuleb)  Skinc)  Muscled)  Articular cartilagee)  Synovial membrane 
Select and explain. 
A. ae, B. b, C. ab, D. ad
A: ae
Answer: A: ae 
Explanation: Tophi are pathognomic of gout. They are formed by large aggregations of urate crystals. The urate crystals are surrounded by -


Macrophages
Lymphocytes
Large foreign body giant cells


They are seen in the-


Articular cartilages of joints
Periarticular ligaments
Tendons and soft tissues
Achilles tendon
Ear lobes


Less common sites of involvement are -

a) Kidney
b) Nasal cartilage
c)  Skin of the finger tips, palms or soles.