[65M] With sharp foot pain and swelling

Patient Description

A 65-year-old male presents with a 5-day history of gradually worsening sharp pain and swelling in the left foot, localized to the top right side near the big toe. The area is described as red and warm, with pain exacerbated by walking. There is no history of recent foot injury, fever, chills, skin changes, or open sores. The patient's medical history is unremarkable with no known chronic illnesses or allergies. Currently, the patient is taking Lisinopril, with no other medications reported.

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Arora's Assessment

What might be happening

Based on the information you provided, the most likely causes of your symptoms are:

  • Gout: This is a type of arthritis that usually affects the joint at the base of the big toe. It is caused by a buildup of uric acid in the body, which forms sharp crystals in the joints. These crystals can cause sudden, severe pain, redness, and swelling. Gout attacks often start in one joint and can begin at any time of day.

    • Treatment for gout usually involves medications to control pain and inflammation, and to lower uric acid levels to prevent future attacks.
  • Bunion: This is a bony bump that forms on the joint at the base of your big toe. It forms when some of the bones in the front part of your foot move out of place. This causes the tip of your big toe to get pulled toward the smaller toes and forces the joint at the base of your big toe to stick out. The skin over the bunion might be red and sore.

    • Treatment for bunions usually involves wearing comfortable shoes with a wide toe box, and avoiding activities that cause bunion pain, such as standing for long periods. If your bunion is very painful, your doctor might recommend surgery.
  • Infection: If you have an open sore or cut on your foot, it could have become infected. Infections can cause redness, swelling, and pain.

    • Treatment for infections usually involves antibiotics.

What you can do

You should make an appointment to see your doctor as soon as possible. In the meantime, you can try the following to help alleviate your symptoms:

  1. Rest your foot and avoid activities that make your pain worse.
  2. Apply an ice pack to your foot for 15 minutes at a time to help reduce swelling.
  3. Elevate your foot to help reduce swelling.
  4. Over-the-counter pain relievers, such as ibuprofen, can help reduce pain and inflammation.

What you should look out for

You should seek immediate medical attention if:

  • Your pain becomes severe or unbearable.
  • You have a high fever or chills.
  • You notice pus or other signs of infection, such as a foul smell coming from your foot.
  • You have difficulty walking or bearing weight on your foot.

Please remember that while I strive to provide accurate and helpful health information, I am an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of gout and how is it diagnosed?

Common symptoms of gout include sudden and severe pain in a joint, redness, swelling, and warmth over the affected area. It is often diagnosed through a physical examination, blood tests to measure uric acid levels, and sometimes joint fluid analysis to detect uric acid crystals.


How can I differentiate between a bunion and gout?

Gout typically presents with sudden, severe pain and swelling in the joint, often at the base of the big toe, and is associated with high uric acid levels. A bunion is a bony bump that forms on the joint at the base of the big toe, causing the toe to deviate towards the others, and is usually a gradual process. A healthcare provider can help differentiate between the two through examination and possibly imaging.


What lifestyle changes can help prevent gout attacks?

To help prevent gout attacks, it is recommended to maintain a healthy weight, limit alcohol intake, especially beer, avoid foods high in purines like red meat and seafood, stay hydrated, and possibly take medications prescribed by a doctor to lower uric acid levels.


When should I seek medical attention for foot pain and swelling?

You should seek medical attention if the pain becomes severe or unbearable, if you develop a high fever or chills, if there are signs of infection such as pus or a foul smell, or if you have difficulty walking or bearing weight on the foot.


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