Hi there, I have had a extremley sharp pain come on suddenly in my left big toe twice in a month. there has been no accident or trauma to the toe. after the pain subsides(it is mainly concerntrated in the top of the toe), the next day the toe feels numb and i am left with what looks like burst blood vessels that are or the side of the toe graduating out from the very side by the nail. The blood vessel/bruise like mark goes down after a couple of days. Can you tell me what it is please?
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You must seriously consider gout. This is due to high uric acid in the body that gets accumulated in the joints. Gout usually attacks the big toe (approximately 75 percent of first attacks). If all infection and injury are ruled out, and rheumatoid factor is normal, then isolated sore toe is considered to be due to gout even in presence of normal uric acid levels. The only confirmed diagnosis is finding the presence of uric acid crystals in the joint fluid. Most doctors do not resort to this and start treatment with nonsteroidal anti-inflammatory medications (NSAIDs). Usually patients respond to it. Another medication, colchicine, is very effective in gout.
Another possibility is Chondrocalcinosis which is similar to gout but caused by deposition of calcium pyrophosphate rather than uric acid. The third possibility is rheumatoid arthritis. This can be diagnosed by positive RF and ANA.
Pain in big toe can be also be due to pinched nerve, poor circulation, faulty foot wear, diabetic neuropathy, leprosy, nerve injury, multiple sclerosis and frost bite. This needs to be investigated before a final cause can be pin pointed.
Since I cannot examine you and know other related conditions you may be having, nor is a detailed history possible on net, I have listed the various possibilities that should be looked into. Please consult your PCP to run tests and examination to clinch a diagnosis.
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