Differential Diagnosis for 59-year-old Male with Foot Symptoms
- Single most likely diagnosis
- Gout: The patient's symptoms of acute onset of redness, swelling, and pain in the toes, particularly the great toe, are classic for gout. The improvement with ibuprofen also supports this diagnosis, as nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat gout.
- Other Likely diagnoses
- Cellulitis: The patient's initial symptoms of redness, swelling, and pain could also be consistent with cellulitis, a bacterial skin infection. However, the improvement with ibuprofen and the specific location of the symptoms make gout more likely.
- Bursitis: Inflammation of the bursae in the foot could cause pain and swelling, particularly in the areas described. However, the pattern of symptoms and the response to ibuprofen are more suggestive of gout.
- Overuse injury or strain: The patient's symptoms could also be due to an overuse injury or strain, particularly if he has recently increased his activity level. However, the specific location and pattern of symptoms make this less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteomyelitis: Although less likely, osteomyelitis (bone infection) could present with similar symptoms and would require prompt treatment to avoid serious complications.
- Deep vein thrombosis (DVT): DVT could cause swelling and pain in the foot and leg, and would require urgent treatment to prevent pulmonary embolism.
- Septic arthritis: Bacterial infection of the joint could cause severe pain, swelling, and redness, and would require prompt treatment to avoid joint destruction.
- Rare diagnoses
- Pseudogout (calcium pyrophosphate deposition disease): This condition could cause similar symptoms to gout, but is less common and would require specific diagnostic tests to confirm.
- Rheumatoid arthritis: Although less likely in a single foot, rheumatoid arthritis could cause pain, swelling, and stiffness in the feet, and would require specific diagnostic tests to confirm.
- Neuroma: A neuroma (benign nerve tumor) could cause pain and swelling in the foot, particularly in the areas between the toes. However, the pattern of symptoms and the response to ibuprofen make this less likely.