T: 38°C
BP: 150/95 mmHg
Obese
Unable to weight bear on left

Examination of John's left first metatarsophalangeal joint reveals a swollen, red, hot and extremely tender joint with a marked venous congestion.

There is no evidence of gouty tophi (in helix of ear, olecranon, bursa or digits) and nor is there evidence of pathology in any other joint.

Other findings:

• No evidence of gouty tophi or pathology in any other joint
• No evidence of local osteomyelitis, infection or penetrating wounds or recent joint injection.
  

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