Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe joint pain, swelling, erythema, and warmth, reaching peak intensity within 24 hours. Symptoms localized to [Joint Name, e.g., 1st MTP joint]. Patient reports recent triggers including [dietary intake/alcohol/dehydration/medication change]. Denies fever, chills, or trauma. Pain is described as [sharp/throbbing] and exacerbated by minimal contact or weight-bearing.
Clinical Examination Findings
Affected joint [Joint Name] demonstrates significant erythema, edema, and exquisite tenderness to palpation. Range of motion is severely limited by pain. No evidence of overlying skin breakdown or cellulitis. Systemic examination: Afebrile, hemodynamically stable. No evidence of polyarticular involvement or tophi noted on physical inspection.
Treatment Protocol
Initiate acute flare management: 1. NSAIDs (e.g., Naproxen or Indomethacin) or Colchicine (if within 24-36 hours of onset). 2. Consider intra-articular corticosteroid injection if monoarticular and infection is ruled out. 3. Recommend RICE protocol (Rest, Ice, Compression, Elevation). 4. Continue home maintenance therapy (e.g., Allopurinol) if already prescribed; do not initiate urate-lowering therapy during acute flare. 5. Follow-up in [Number] days to assess response.