A man has a sudden red, swollen and very painful first metatarsophalangeal joint after a heavy meal and alcohol. What is the most likely diagnosis?
Answer and explanation
Correct answer: C. Acute gout
- Step 1: The picture of sudden pain in the first metatarsophalangeal joint fits Acute gout.
Answer
Acute gout.
Why not the others: 'Septic arthritis': it gives a hot joint with systemic fever and needs urgent aspiration. 'Pseudogout': it affects older patients, often the knee, with positively birefringent crystals. 'Cellulitis of the foot': it is a spreading skin infection with no joint effusion.
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