What is the cause of nocturnal burning sensation and pulsation in the left hallux (big toe)?

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Differential Diagnosis for Left Big Toe Burns and Pulsates at Night

  • Single most likely diagnosis
    • Gout: This condition is characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in the joints, often occurring at night. The big toe is a common site for gout attacks, which can cause a burning sensation and pulsating pain.
  • Other Likely diagnoses
    • Ingrown toenail: An ingrown toenail can cause pain, swelling, and redness in the toe, especially if it becomes infected. The pain can be worse at night and may feel like burning or pulsating.
    • Morton's neuroma: This condition involves a thickening of the tissue around the nerves leading to the toes, causing pain, burning, and numbness in the foot, particularly between the toes.
    • Poor circulation: Reduced blood flow to the feet can cause pain, burning, and pulsating sensations, especially at night when the feet are elevated.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Diabetic neuropathy: Uncontrolled diabetes can cause nerve damage, leading to burning, tingling, and pulsating pain in the feet, which can be severe and debilitating if left untreated.
    • Deep vein thrombosis (DVT): A blood clot in the deep veins of the leg can cause pain, swelling, and warmth in the affected area, which may be worse at night.
    • Cellulitis: A bacterial infection of the skin and underlying tissues can cause redness, swelling, warmth, and pain, which can be severe and potentially life-threatening if not treated promptly.
  • Rare diagnoses
    • Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, often occurring in response to heat or exercise.
    • Complex regional pain syndrome (CRPS): A chronic pain condition that can cause burning, tingling, and pulsating pain in the affected limb, often following an injury or trauma.
    • Peripheral artery disease (PAD): A condition characterized by narrowed or blocked arteries in the legs, which can cause pain, cramping, and weakness in the legs, especially during exercise or at night.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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