Case presentation A 68-y ear-old re tired male plumber presented to the hospital with severe pain and swelling in his left foot at the base of his first metatarsophalangeal (MTP) joint. The patient also reported right knee and medial malleolar pain, which he described as vague, mild epigastric pain without any symptoms of nausea, vomiting, diarrhea, melena or hematochezia. The patient further reported that his symptoms started appearing several months ago during which he did not experience any fever or chills.
He reported stable weight and normal appetite. However, he mentioned experiencing painful skin nodules on his lower extremities. Patient history 30 years of smoking history which he quit 8 years ago Hypertension, hyperlipidemia, hypothyroidism, recurrent pancreatitis, gastroesophageal reflux disease, and Barrett's esophagus Previous surgical history consisted of Nissen…
