Gout.

Mikuls, Ted R · N Engl J Med · 2022

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Abstract

A 64-year-old man presents with foot pain. Unable to bear weight, he reports redness and swelling in his foot. He had similar past episodes involving his big toe and elbow that were alleviated with naproxen. He has hypertension, Type 2 diabetes, and moderate chronic kidney disease (CKD). Examination reveals warmth and redness in the left first metatarsophalangeal joint that is exquisitely tender. He has nodules over both elbows. How should the patient be evaluated and treated?

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