This article answers the short gout question “swollen toes diagnosis”.
For the more information on Swollen Joints, please see my latest addition to the I Have Gout program.
That program is about getting a good diagnosis. It is a step-by-step program that covers all aspects of gout diagnosis, allowing you to assess your symptoms, work with doctors to get a diagnosis, and learn what to do once your swollen joints are diagnosed. If you want to know more about your gout symptoms, please see Is It Swollen Joints Or Tophaceous Gout?
Swollen toes are a common sign of gout, but there could be other reasons.
If you go to the doctors with swollen toes, they will usually start by asking about any possible recent injury. Often swelling can happen a few days after an injury, and this is one of the most common causes. Very tight footwear is another common cause of swollen toes.
Swollen joints have many causes, and if gout is suspected, the procedure is the same for all joints – not just swollen toes.
If there is no obvious trauma explanation, the best diagnosis comes from testing fluid from the affected joint. Some family doctors will do this themselves. Others will refer you to a specialist. In either case, the procedure is quite painless, and not nearly as bad as it sounds.
The procedure is often referred to as aspiration, or arthrocentesis. The doctor draws fluid from the joint with a very fine needle, and arranges for the fluid to be tested.
Where gout is suspected, the lab should be looking for 3 possible outcomes.
First they should rule out infection. Septic arthritis is often mistaken for gout, and vice versa. If septic arthritis is ruled out, the fluid must be examined under microscope for existence of crystals. In fact, this test should always be done as septic arthritis and crystal arthritis can coexist.
The crystal tests are for uric acid crystals (monosodium urate or MSU) and for calcium crystals (Calcium Pyrophosphate Dihydrate or CPD). If the tests show MSU crystals, you have gout. If they show CPD crystals you have pseudogout.
If you are very unlucky, you can have two or even all three of these conditions at the same time.
This should tell you all you enough about swollen toes diagnosis so that you can find out exactly what is wrong and start getting the correct treatment If you need to know more, see the Gout Questions page.