A confession reveals the cause of debilitating knee pain
Julian is 32 and works as a bartender at a club.
Over the past week, he has noticed steadily increasing pain and swelling in his left knee, which is now extremely painful, preventing him from working.
He is unable to weight bear and is feeling generally unwell, with fever, nausea, lack of appetite and some weight loss.
He has never experienced an episode like it before. There is no family history of arthritis and specifically of gout.
Apart from an appendicectomy in childhood Julian has had no prior medical problems