Toe pain and swelling

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Toe pain and swelling
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

Causes can be as simple as trauma or infection. They can also be rheumatoid arthritis, endocarditis or athlerosclerotic vascular disease. The most common cause/complaint is Gout.

Gout can be so excruciating at times that even the weight of a bed sheet is unbearable.

Differential Diagnosis

In alphabetical order. [1] [2]

Laboratory Findings

Imaging Findings

  • Radiographs
  • Fractures
  • Osteomyelitis signs
  • Psoriatic arthritis

Other Diagnostic Studies

  • Synovial fluid analysis
  • Look for an infection, crystals, inflammation
  • Gram stain, polarized light microscopy
  • Cell counts should result in a WBC count less than 50,000/ml if inflamed
  • Cell counts should result in a WBC count greater than 50,000/ml in infectious arthritis

Treatment

Acute Pharmacotherapies

Gout

  • NSAID's
  • Colchicine

Chronic Pharmacotherapies

Gout

Ingrown toenails

  • Warm soaks
  • Toe nail removal

Pseudogout

Reiter's Syndrome

Septic arthritis

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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