23rd February 2024

A 68 year old gentleman presents with an acutely painful and inflamed first metatarsophalangeal joint on the left foot.

A 68 year old gentleman presents with an acutely painful and inflamed first metatarsophalangeal joint on the left foot. The joint is severely painful, making walking difficult and looks swollen and erythematous in comparison to the right foot. Examination of the joint is difficult due to the intense pain, however it feels warm over the affected joint. The patient mentions that he has already had several similar episodes and was prescribed medication last year to try and prevent future ones. He stopped taking this approximately 6 weeks ago because he hadn’t had any new episodes for several months. He has high cholesterol for which he takes Atorvastatin and has Osteoarthritis affecting his left shoulder for which he occasionally takes Paracetamol to reduce the pain. He also mentions he has an allergy to aspirin.

Prescribe one drug that should be started now for this patient.