If you present to your doctor with a red hot swollen tender big toe and severe throbbing pain, then the first thing your doctor will consider is acute gout. This is acute podagra. 70-90% of first attack presents as podagra and commonly affect the first meta-tarso-phalangeal joint.

To help diagnose podagra, your doctor will consider if you had a previous episode. In addition podagra comes on very quickly and the patient will have no other symptoms such as fever or signs of infection. A blood test to check the serum uric acid level is helpful and important but it may take some time before the results are available. Often the initial diagnosis is made and treatment started before the test results are back.

The most accurate way to diagnose gout is by removing some synovial fluid from the affected joint by aspiration and the fluid looked at microscopically for urate crystals. This, however, is not recommended in the big toe because the joint affected is very small and extremely painful even to touch.

A red hot swollen big toe can be caused by an infection such as septic arthritis. The onset, however, is slow and the infection is associated with fever and generally feeling unwell.

When a diagnosis of gout is made, it is also important to uncover potential factors that may trigger gout such as other diseases or thiazide diuretics. Acute gout can uncommonly present in other joints and when this happens, the diagnosis is not that obvious and gout will be on a list of possible diagnoses.

So if you have a painful swollen big toe and you cannot bear anything touching it, it is likely to be acute gout. It will resolve spontaneously in time but this could be weeks. Medication can shorten the time and reduce discomfort. You may not get another attack for years. You do not necessarily have to be on continuous medication. In may be due to your medication or other unrelated medical conditions. True gout is when the uric acid level remains high all by itself. This group will be considered for maintenance therapy.

Dr.Phil Hariram

Arthritis Guide

alternative medicine treatment for arthritis

arthritis laser treatment

arthritis prevention treatment

arthritis symptoms treatment

Arthritis Treatment

arthritis treatment knee pain relief 1st

natural treatment for arthritis

painkillers an effective treatment for arthritis

treatment for severe arthritis of the knee