wtf?...gout!?

[LittleOldLady]

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The big toe is more often involved than other joints. In an acute gout attack, the joint is often so inflammed that any contact (bedsheets, socks, etc) brushing against can be excruciating.

I'd be suspicious of a diagnosis of gout without blood tests or aspiration of the joint space.

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My father had gout, and it was unmistakable in appearance: huge inflamed swelling of the joint in the big toe. ALso my father (who had a high threshhold of pain) was in agony. He was also at high risk due to kidney and the long-term use of diuretics to control blood pressure. Even I could take one look and say "gout." I would imagine that if joints other than the big toe were afflicted, diagnosis might be more difficult.

[GeniusToad]

the gout sucks - hopefully it's just a freak occurance.

[Adam Sandler]

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PHB,

That was the very first thing that popped into my head when I opened this thread.

Hogies and grinders, hogies and grinders, navy beans, navy beans MEATBALL SANDWICH!

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I'm not a nit, but that really hurts man...

[JackCase]

There still seems to be a lot of disagreement as to what causes it or brings on an attack. It is a form of arthritis, and attacks are caused by a build up of uric acid. I have an attack every couple of years, but it has been many years since I had one in the big toe. My last one was on a joint of my little finger, and before that it was bad knee pain.

The short term pain relief is naproxin sodium (Aleve or generic, availble at supermarkets). If you start to get it a lot, black cherry concentrate has a natural chemical that reduces uric acid.

[Hopey]

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I've had pain in my big toe for awhile. I thought I hurt it playing soccer a few months ago, but the pain never went away. It doesn't hurt constantly, but flares up once in awhile.

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Might be turf toe. I jammed my toe really bad in my early teens, and 20 years later, this still flares up from time to time.

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That's probably what it is. My toe had always bothered me a little whener I played any kind of sports that required me wearing cleats. It's when I sprained my ankle and it didn't seem to want to heal that I started worrying about gout. However, my ankle is close to 100% now, and my toe doesn't hurt anywhere near what is described by the OP...so I guess I'm in the clear.

Besides, I'm not anywhere rich enough to suffer from a "rich man's disease" [img]/images/graemlins/smile.gif[/img]

[hobbes9324]

Hmmmm.....don't want to be a nit, but what kind of MD did you see?

In my experience, gout hitting the second toe would be unlikely, to be kind. As one of my medical collegues noted, without doing an aspiration of the joint space (which would be pretty tricky on the joint here....) or a serum uric acid level, I'd hesitate to jump on gout as my first diagnosis.

IMHO, the most likely would be a missed fracture on the inital X-ray (happens up to 2% of the time, depending on who is reading the film) or a septic joint, which would be less likely - but if you get SPREADING redness or a fever - get rechecked. If you're not pain free in say four to five days, get re-X-rayed - frequently, the second film will show the "missed" fracture. "Buddy-taping" #2 to #1 may help.

Good luck

MM MD

[offTopic]

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http://www.bartleby.com/109/3.html

III. Dialogue Between Franklin and the Gout

Benjamin Franklin (1706–1790)

Midnight, 22 October, 1780.


FRANKLIN. Eh! Oh! eh! What have I done to merit these cruel sufferings?

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"Are! Oh! Eff! Ell! Em! Eh! Oh!"

[Victor]

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Hmmmm.....don't want to be a nit, but what kind of MD did you see?

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i went to what is called an "urgent care" center. its like an emergency room in that you can show up off the street but as you must the right insurance.

the doc who saw me was an md. his card says "board certified internal medicine. family phsicians associate." he also has a private practice.

[dizong]

like some others have mentioned, I'd be a little skeptical of gout as a diagnosis here. the key to diagnosis is joint fluid aspiration (stick a needle in the joint, drain some joint liquid). you may have some tendinitis or maybe even a fracture that was missed or not detected by xray. i doubt gout because reasonably healthy 25 yr olds usually don't get gout.

[Victor]

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i doubt gout because reasonably healthy 25 yr olds usually don't get gout.

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gawd i hope all you guys saying this are right since everything ive said this [censored] sucks. im torn tho. i want the pain to go away so i hope the meds i got work which would mean i am hoping for gout.