Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe pain, erythema, and swelling 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 (bedsheet sign). No history of recent trauma. Denies fever or chills.
Clinical Examination Findings
Right foot: Inspection reveals marked erythema, edema, and warmth over the first MTP joint. Palpation elicits extreme tenderness and exquisite pain with range of motion. No fluctuance or open skin lesions noted. Neurovascular status intact distally.
Treatment Protocol
1. NSAIDs (e.g., Naproxen 500mg BID or Indomethacin 50mg TID) for 5-7 days. 2. Colchicine 1.2mg stat, followed by 0.6mg in 1 hour. 3. Consider intra-articular corticosteroid injection if NSAIDs/Colchicine are contraindicated. 4. Elevate extremity and apply ice packs for 15 minutes every 2-4 hours. 5. Follow-up for serum uric acid levels in 2-4 weeks.