Last month, I saw a woman with a few weeks’ history of pain and swelling around her left ankle.

She hadn’t injured it and she had no history of gout or arthritis. It was swollen and tender but not red or warm. Moving it hurt her and she walked with a limp.

I ordered an X-ray, which was negative, and some bloodwork. Her inflammatory markers were high, uric acid level was normal and antinuclear antibodies and rheumatoid factor were negative. I prescribed a nonsteroidal and referred her to orthopedics.

Almost a month later I got a call. It was the orthopod: