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I'm 54 years old and have had foot problems for about 8 years. I've had attacks in my big toe, both right and left , my pinky toe and once in my right elbow. None of these attacks have looked like traditional gout. They look swollen ,but never that bulbous golf ball look.sometimes in the past but not so too recently , its been the type of attack where you cant get a shoe on or cant put a sheet on it. That hasn't happened recently though. I've seen various doctors over the years, was needled two times ,never found uric acid crystals. my latest Rhuematologist is sending me for an MRI of my foot to identify the problem. She looked at my xray's and believed she saw some calcium in my joints,which would point to psuedogout. i also have slightly pitted nails which could point to Psoriatic arthritis although i dont have psoriasis. i should mention my uric acid levels have been very high and climbing since about 20 years ago. i remember a doctor telling me to keep an eye on my uric acid level that long ago.. i dont know what the level was then but i've checked back through the years and it hasnt been below 6 in years .. i've steadily gone from normal to 7,8.9 and now 10.3.. which of course seems to indicate gout. my problem is i think complicated by the fact that my feet have fallen apart and my joints are stressed and i use orthodics to help them . i have hallux limitis. so this makes it hard to seperate gout from straight foot inflamation. by the way my diet is very good and i dont drink and i'm not over weight.well not too much 5'11″ 185lbs.
Recently since late august i get minor attacks that go back and forth from one foot to the other.i have had only a few days since then that i dont have some pain. the attacks are sometimes in the usual big toe joint but other times the tip of the left toe(this hasnt happened in my right toe), also in both feet the pain has started in between the big toe and the second toe on top and extends down thru the bottom of my foot.. this results in a feeling like my toe is jammed together causing it to be rigid. Woke up yesterday, after two days of relative calming of my left toe, with it returning in my right foot big toe.. medium pain ..i can still get a shoe on and walk.
My question is can gout just keep bouncing around from foot to foot with medium pain or does this sound like something else? In the past i would get a bout or two in a row then not have an attack for a few years. This seems a little different.
By the way my docs choice of uric acid lowering drug is Uloric, but havent tried it yet. Cant wait for that gout flare…..in transition….
thanks
john
John,
You have a confusing array of possibilities between Hallux limitus, pseudogout and gout. So anyone looking at an X-ray seeing deposits will not be able to easily differentiate…all three conditions cause deposits and two of them calcium and all three cause foot pain at the bunion joint. Odds are good though that you have only ONE condition…I'm fond of Occam's Razor!
I would give a try wilth allopurinol (or Uloric if you have good insurance and don't mind taking a brand new expensive drug) for a year or so and making sure ALL your uric acid readings are below 6.0, or better yet 5.0 if you have visible deposits.
If much of your pain goes away, you have your answer. If not, you can pursue the other possible diagnoses.
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