Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe pain, swelling, and erythema localized to the right first metatarsophalangeal (MTP) joint. Symptoms began [insert time, e.g., 24 hours] ago, reaching peak intensity rapidly. Patient reports inability to bear weight or tolerate contact with bedsheets (podagra). No history of recent trauma. Denies fever or chills.
Clinical Examination Findings
Right foot examination reveals marked erythema, warmth, and significant edema over the first MTP joint. Tenderness to palpation is exquisite. Range of motion at the right first MTP joint is severely limited due to pain. No signs of cellulitis, ulceration, or fluctuance. Distal neurovascular status is intact.
Treatment Protocol
1. Initiate NSAIDs (e.g., Indomethacin or Naproxen) or Colchicine as per protocol. 2. Consider intra-articular corticosteroid injection if systemic therapy is contraindicated. 3. Recommend RICE protocol (Rest, Ice, Compression, Elevation). 4. Hydration and dietary counseling regarding low-purine intake. 5. Follow-up in 1 week to assess response and discuss long-term urate-lowering therapy.