Differential Diagnosis for Painful Right Big Toe

• Single most likely diagnosis
  • Gout: This is the most likely diagnosis given the acute onset of pain, redness, and swelling in the big toe, which is a classic presentation of gout. The big toe is the most common site for gout attacks.
• Other Likely diagnoses
  • Cellulitis: Bacterial infection of the skin and soft tissues can cause redness, swelling, and pain, which could be considered given the symptoms.
  • Ingrown Toenail: An ingrown toenail can cause pain, redness, and swelling, especially if it becomes infected.
  • Trauma: Recent trauma to the toe could lead to pain, swelling, and redness.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Osteomyelitis: Bone infection, although less common, can present with similar symptoms and has serious consequences if not treated promptly.
  • Septic Arthritis: Infection within the joint can cause severe pain, redness, and swelling, and if not treated, can lead to joint destruction.
  • Deep Vein Thrombosis (DVT): Although less common in the toe, DVT can cause swelling and pain and is a medical emergency due to the risk of pulmonary embolism.
• Rare diagnoses
  • Pseudogout: Calcium pyrophosphate deposition disease (CPPD) can cause acute arthritis similar to gout but is less common.
  • Rheumatoid Arthritis: Although it typically affects multiple joints, rheumatoid arthritis can start in a single joint and cause similar symptoms.
  • Sickle Cell Crisis: In individuals with sickle cell disease, a crisis can cause pain and swelling in the toes due to vaso-occlusive episodes.