Chief Complaint: pain and swelling in ankle and feet, alcohol abuse
Medical History: Patient: 53 year old female
Occupation: art student
History: family history of alcoholism, pain in legs since 1978
Current presentation: Patient has stiffness and swelling in her feet and ankles making ambulation difficult. The pain is 8-9 on a scale of 0-10 with deep, heavy, sharp quality that is worse at night. She can recall no injury or precipitating factors. Feet are cool to touch, soft, pale with non-pitting edema. The patient smokes and drinks six beers a night. She eats cold foods for lunch.