Differential Diagnosis for Middle of Index Toe Swelling, Redness, and Pain
Single Most Likely Diagnosis
- Gout: This is a common condition characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in the joints, often occurring at the base of the big toe but can also affect other toes. The symptoms described, especially pain when ambulating, are classic for gout, which is often precipitated by trauma, dietary factors, or alcohol consumption.
Other Likely Diagnoses
- Ingrown Toenail: This condition occurs when the corner of a toenail grows into the surrounding skin, causing pain, redness, and swelling. It's a common issue, especially in the toes, and can be exacerbated by walking or pressure on the toe.
- Cellulitis: A bacterial skin infection that can cause redness, swelling, and pain. It often occurs after a break in the skin, such as a cut or scratch, and can spread rapidly.
- Osteoarthritis: While less common in the toes compared to other joints, osteoarthritis can cause pain, swelling, and stiffness, especially with weight-bearing activities like walking.
Do Not Miss Diagnoses
- Osteomyelitis: A bone infection that can cause pain, redness, and swelling. It's less common but critical to diagnose early because it can lead to serious complications, including bone destruction and sepsis.
- Deep Vein Thrombosis (DVT): Although DVT typically presents in the calf, it can occasionally cause swelling and pain in the foot or toes. Missing this diagnosis can be fatal due to the risk of pulmonary embolism.
- Septic Arthritis: A joint infection that can cause severe pain, redness, and swelling. It's a medical emergency requiring prompt antibiotic treatment to prevent joint destruction.
Rare Diagnoses
- Psoriatic Arthritis: An autoimmune condition that can cause joint pain, swelling, and stiffness, along with skin psoriasis. It's less common and might be considered if other diagnoses are ruled out and there's a history of psoriasis.
- Reactive Arthritis: A type of arthritis that occurs as a reaction to an infection elsewhere in the body, often in the gastrointestinal tract or the urethra. It can cause toe swelling and pain but is relatively rare.
- Erythromelalgia: A disorder that causes burning pain, heat, and redness in the hands and feet, which can be primary or secondary to other conditions like myeloproliferative disorders. It's rare and might be considered if other diagnoses are excluded.