Case Discussion: pain in the great toeCreated by:
A 35 years old man presented to emergency department with severe pain in his right great toe. The pain is so severe and rapid in onset which compelled the patient to wake up in the early morning. He described it as the worst pain ever. There was extreme tenderness for which he is unable to wear a sock. On examination, there was marked swelling with red shiny skin over first metatarsophalangial joint. There was no pain in any other joint there is no history of injury.
From these clinical features, what is the most probable diagnosis?
What are the investigation required and how will you manage the case?