Patient presents with acute onset of monoarticular inflammatory arthritis, consistent with gout.  The patient reports severe pain, redness, swelling, and tenderness in the right great toe (podagra), which began acutely overnight.  Symptoms include limited range of motion and warmth at the affected joint.  Patient denies fever or chills.  On physical examination, marked erythema, edema, and exquisite tenderness are noted in the right first metatarsophalangeal joint.  The patient's past medical history includes hyperuricemia and hypertension.  Family history is positive for gout.  Differential diagnosis includes septic arthritis, pseudogout, and rheumatoid arthritis.  Serum uric acid level is elevated.  Synovial fluid analysis is consistent with gout, demonstrating negatively birefringent monosodium urate crystals.  Diagnosis of acute gouty arthritis is confirmed.  Treatment plan includes initiation of NSAID therapy with indomethacin for pain and inflammation management.  Colchicine is prescribed for acute flare prophylaxis.  Patient education provided on lifestyle modifications including dietary adjustments to limit purine-rich foods, increased hydration, and weight management.  Follow-up appointment scheduled to monitor treatment response and discuss long-term urate-lowering therapy options such as allopurinol or febuxostat for prevention of future gout attacks.  ICD-10 code M10.001 assigned for right great toe gout.  CPT codes for evaluation and management services and joint aspiration documented.