[Answered]: A 52-year-old male presents to the emergency room…

A 52-year-old male presents to the emergency room with complaints of pain to his left great toe since yesterday. He reports that the pain is a 10/10 and that he can’t handle a sheet touching his foot. He denies any injury to the foot. The patient reports that he attended a company party for the holidays and his symptoms started after that event. The patient has a history of hypertension and high cholesterol. He is currently taking HCTZ 12.5 mg po daily and Simvastatin 20mg po daily. The patient’s vital signs: His BP is 128/84, pulse is 70, resp 18, regular and non-labored, pulse ox 98%, and temp 100.1F. Physical exam reveals the first metatarsal phalangeal joint is erythematous and edematous. Exam is otherwise unremarkable. Diagnostic testing: Uric acid: 10 mg/dl; ESR 32mm/hr. Xray Left great toe: Normal joint space, no erosion.