What is the most likely diagnosis? 
              
- 65 year-old with elbow pain

                
                Lateral Radiograph of Elbow
              
                - Synovioma
- Giant Cell Tumor of Tendon Sheath
- Gout
- Olecranon Fracture
- Osteochondritis Dissecans
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                  Answer:
               
              
                3. Gout
                 
              
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              Gout
                  
              
              General  Considerations
              
                - Deposition of sodium       urate monohydrate crystals in synovial membranes, articular cartilage,       ligaments, bursae leading to destruction of cartilage
- Age of onset is usually       greater than 40 years; males much more often than females
- Radiologic features       usually not seen until 6-12 years after initial attack
- Radiologic features       present in 50% of affected patients