A 65-year-old truck driver comes to the emergency room becau…

A 65-year-old truck driver comes to the emergency room because he had a sudden onset of intense pain in his left great toe. He denies any trauma or injury to his foot. On physical examination, he has a red, swollen, painful metatarsalphalangeal (MTP) joint on the great toe. The swelling extends beyond the margin of the joint. He denies fever or chills. There is no fluctuance during palpation of the swollen area. What is your most likely diagnosis?