8th September 2020

A 57-year-old lorry driver presents with acute unbearable pain over his left big toe

A 57-year-old lorry driver presents with acute unbearable pain over his left big toe. He explains that the pain began while he was asleep and is the worst pain he has ever experienced. He visits his GP regularly for review of his hypertension and diabetes and has recently been commenced on Bendroflumethiazide. On examination, you notice he is obese and walks with a limp. The first metatarsophalangeal joint is erythematous, swollen, warm and tender to touch. All remaining joints are normal. 

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.