A 58-year-old man presents to the emergency department with excruciating pain, swelling, and erythema of his left first metatarsophalangeal joint that began last night. He reports that the pain started several hours after a celebratory dinner featuring steak and multiple glasses of red wine. On physical examination, the joint is warm, tender, and exquisitely painful to light touch. Laboratory studies reveal a serum uric acid level of 9.2 mg/dL (normal 3.5–7.2 mg/dL). Arthrocentesis yields fluid containing needle-shaped, negatively birefringent crystals under polarized light. Which of the following best explains the acute pathophysiologic mechanism leading to this patient’s symptoms?
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