Patient’s Data​

Patient’s Name: Richard Palmer

Age: 61-year-old male

Past Medical History:

• Hypertension

Drug and Allergy History:

• Amlodipine 10mg OD
• No Known Drug Allergy 

Recent Notes/Consultation:

Letter from St Mary’s Urgent Care Service (3 days ago) 

 To: General Practitioner
Re: Mr. Richard Palmer | 61 years old | Male

Dear Colleague,

Mr. Richard Palmer presented to the Urgent Care Centre with a rapid-onset swelling and severe pain affecting the right first metatarsophalangeal (MTP) joint, which developed overnight. Clinical examination revealed redness, swelling, and tenderness consistent with an acute gout flare.

He was systemically well with no fever or constitutional symptoms, and there were no features to suggest septic arthritis at the time of review.

A blood test showed an elevated serum uric acid level of 350 µmol/L. A diagnosis of acute gout was made.

He was commenced on colchicine 500 micrograms four times daily for 3 days. He was safety-netted appropriately, including advice regarding signs of septic arthritis and when to seek urgent medical attention.

Mr. Palmer was advised to follow up with his GP once the acute flare has resolved to discuss the possibility of initiating urate-lowering therapy to reduce the risk of future attacks.

Kind regards,
Dr Kelechi Onwudiwe, MBBS, MRCGP, MRCEM
Urgent Care Physician

Patient booked an urgent telephone appointment to discuss concerns