I recently had a biopsy done from tissue removed during surgery to have my big toe fused. The reason for the biopsy was at the request of my rheumatologist because of pain in my hand (unrelated to the foot problem or so I thought). X-rays of my hand showed inflammatory arthritis with deep cut outs or grooves (no really sure what they are actually called) especially in the little finger which is were my problem lives. Any way, the biopsy showed gout crystals. This puzzled my rheumatologist and my foot surgeon since blood tests showed very low uric acid. The rheumatologist is leaning towards psoriatic arthritis (my grand mother suffered from psoriasis). My foot surgeon disagrees at least based on both my foot xrays and what she saw during surgery. Any thoughts?