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Physical examination shows warmth and swelling of both knees with large effusions.
Arthrocentesis of the right knee reveals the presence of intracellular and extracellular weakly positive birefringent crystals in the synovial fluid. Gram stain is negative. Which of the following is the most likely diagnosis?

A. Gout
B. Septic arthritis
C. Calcium oxalate deposition disease
D. Reactive
E. Pseudogout

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pseudogout,,,,
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