Gout

A 64-year-old man presents with pain in the left foot. The patient's foot is red and swollen, and he is unable to bear weight on it. He has had similar past episodes involving the big toe of the right foot and the right elbow that were alleviated with naproxen. He has hypertension, type 2 diabetes, and moderate chronic kidney disease (CKD). Physical examination reveals warmth and redness in the left first metatarsophalangeal joint, which is exquisitely tender. He has nodules over both elbows. How should the patient be evaluated and treated?

Automated summary

A 64-year-old man presents with pain, redness, and swelling in his left foot, and is unable to bear weight on it. He has a history of similar episodes in his right big toe and right elbow, which were relieved with naproxen. He also has hypertension, type 2 diabetes, and moderate chronic kidney disease. Physical examination reveals warmth, redness, and nodules in the left first metatarsophalangeal joint.