Differential Diagnosis for Redness and Pain on the 2nd Toe, Proximal Interphalangeal Joint
- Single most likely diagnosis
- Gout: This is a common condition characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, often occurring at the base of the big toe but can also affect other toes. The proximal interphalangeal joint of the 2nd toe is a less common but possible location for a gout attack.
- Other Likely diagnoses
- Pseudogout (Calcium Pyrophosphate Deposition Disease, CPPD): Similar to gout, pseudogout causes sudden, severe joint pain and swelling, but it is caused by calcium pyrophosphate dihydrate crystals. It can affect various joints, including those in the toes.
- Septic Arthritis: An infection within the joint, which can cause pain, redness, and swelling. It's a serious condition that requires prompt treatment.
- Osteoarthritis: While more commonly associated with chronic pain and less with acute redness, osteoarthritis can cause pain and stiffness in the joints of the toes, including the proximal interphalangeal joint.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cellulitis or Soft Tissue Infection: Bacterial infections of the skin and soft tissues can spread and become severe. Early recognition and treatment are crucial.
- Necrotizing Fasciitis: A rare but life-threatening infection that destroys the tissue under the skin, including fat and the tissue covering the muscles (fascia). It requires immediate medical attention.
- Osteomyelitis: An infection of the bone, which can be a complication of a skin infection and can lead to serious consequences if not treated promptly.
- Rare diagnoses
- Psoriatic Arthritis: A form of arthritis that affects some people who have psoriasis, causing joint pain, swelling, and stiffness. It can affect any joint, including those in the toes.
- Rheumatoid Arthritis: Although less common in the toes, rheumatoid arthritis can cause pain, swelling, and stiffness in various joints, including the proximal interphalangeal joints.
- Sarcoidosis: A condition in which inflammatory cells (granulomas) form in various organs, including the joints, causing pain and swelling. It's a rare cause of joint symptoms in the toes.