gout or fracture?

[tjacked]

I have been experiencing pain in my right big toe over the last few weeks. It started as severe pain, mostly in the front joint of the toe and radiating out from there. There was increased pain to the touch. The pain subsided for a week and has come back again this week. When I initially had the pain, I visited 2 podiatrists. The first one thought he saw a slight fracture or crack in my toe on x-ray. The second one dismissed this and said I had gout. He gave me colchacine and an antibiotic because he thought the toe might be infected as well. I could only take the meds for a few days due to extreme stomach upset. The pain seemed to get better over those few days, but not sure if it was from the meds or simply staying off the foot. The pain continued to get better even after stopping the meds.

So now, my question is this; does this sound more like gout or a fracture of some kind? My understanding was that gout typically attacks the larger joint of the big toe, not the front joint. The recurrences don't seem to be tied to a specific dietary change from what i can tell, but the pain seems worst in the morning. I've been applying heat a few times a day and that seems to help a bit.

Thank you.

[tjacked]

i do have a history of hallux limitus in both feet. went to my regular podistrist today and he ordered a uric acid test. he thinks it may just be related to the hallux limitus, but wants to test to rule out (or in) gout. he did not see any crack or break on the x-ray. thanks for the reply.

[Yena H Do, DPM]

it is difficult to assess w/o seeing the xray and the toe.  you should get a uric acid test to see if you do have gout.  did you have history of an injury?  if not, most likely it is not a fracture.
if you had a fracture, the pain doesn't subside and then get worse unless you reaggravated it.  ice makes gout worse whereby heat makes it better.  ice makes fractues better, whereby heat worsens it.
it sounds like gout...but then again, you will need blood workup and possibly a joint aspiration to see if it is so.