Taylor Tophus is a 65-year-old white female who presents to your urgent care clinic complaining of severe left thumb pain. She reports pain began last night with significant swelling and new-onset redness of her thumb’s metacarpophalangeal joint (MPJ). Her symptoms have progressively worsened into the morning hours. Taylor states she routinely sees a rheumatologist and was diagnosed with acute gouty arthritis 9 years ago. She states she will have an acute attack approximately every 3-4 months. Taylor reports she broke her ankle 6 months ago. Her ankle has not completely healed, and she is having minimal pain. She is being treated by an outside orthopedist and is wearing a lace-up ankle brace.