Review Question - QID 217354

A 62-year-old male presents with acute onset left wrist pain. He denies any injury to the wrist. His past medical history is unremarkable and he denies any intravenous drug use. He is afebrile and pain is located only in the left wrist. Radiographs are unremarkable. The wrist is red, hot to the touch, and painful with motion. He undergoes an aspiration of the joint and is ultimately treated with anti-inflammatory medication for gout. Which of the following findings is consistent with gout on crystal analysis?