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Mis-diagnosis for gout?
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Gout is a common and painful form of arthritis that causes swollen, red, hot and stiff joints when uric acid builds up in the blood. Discuss topics including symptoms and medical or alternative treatments for gout.

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Mis-diagnosis for gout?

For the past 2 years or so, every 3-4 weeks I would wake up and the top and left side of my left foot would hurt. There would also be a slight redness. Over the course of the day, it would usually wear off, though sometimes it would last for up to 2-3 days.

About two weeks ago, the condition got much worse. The pain became so intense I go to the ER. They made a sight diagnosis (i.e. not the test that 100% determines whether you have gout or not) of gout and gave me some anti-inflamatories and a pain killer (hydrocodone). This lessened the pain a bit, but not for long. After another week, it got worse again, this time with severe swelling across most of the top of my foot except for my toes. There is also a considerable amount of "redness" across the top. I've had no pain from my toes or the ball of foot, but pretty much everywhere else.

Given the location, I was wondering if this might not be gout but something different. If it is gout, I'm not sure which joint it would actually be hitting and from my reading, it wouldn't be any of the "usual" joints where gout occurs.

The pain is so bad now that the hydrocodone does very little for the pain and it takes a sheer effort of the will to walk at all.

Just wanted to know what others think. Thanks.

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Hello Dear,

Gout is condition that results from crystals of uric acid depositing in tissues of the body. Gout is characterized by an overload of uric acid in the body and recurring attacksof joint inflammation.The small joint at the base of the big toe is the most common site of an acute gout attack. Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows. Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness. Tenderness can be intense so that even a blanket touching the skin over the affected joint can be unbearable. There may be fever with the acute gout attacks. These painful attacks usually subside in hours to days, with or without medication. In rare instances, an attack can last for weeks. The most reliable test for gout is finding uric acid crystals in the joint fluid obtained by joint aspiration (arthrocentesis). Arthrocentesis is a common office procedure performed under local anesthesia. Using sterile technique, fluid is withdrawn (aspirated) from the inflamed joint, using a syringe and needle. The joint fluid is then analyzed for uric acid crystals and for infection. Shiny, needle-like uric acid crystals are best viewed with a polarizing microscope. The diagnosis of gout can also be made by finding these urate crystals from material aspirated from tophi nodules and bursitis fluid. Anti-inflammatory agents such as nonsteroidal antiinflammatory drugs (NSAIDS), colchicine, and corticosteroids are used to decrease joint inflammation. Preventing acute gout attacks is equally as important as treating the acute arthritis. Prevention of acute gout involves maintaining adequate fluid intake, weight reduction, dietary changes, reduction in alcohol consumption, and medications to reduce hyperuricemia. You should consult a good doctor and proper diagnosis should be done and treatment should be started.
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