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Differential Diagnosis for Big Toe Pain (not Gout)

Single Most Likely Diagnosis

  • Osteoarthritis: This is a common condition that can cause pain in the big toe, especially if there's a history of trauma, repetitive strain, or degenerative changes. The pain is typically worse with movement and improves with rest.

Other Likely Diagnoses

  • Sesamoiditis: Inflammation of the sesamoid bones under the first metatarsal bone can cause pain in the big toe, often related to overuse or poor footwear.
  • Bursitis: Inflammation of the bursae around the joints of the big toe can cause pain, swelling, and redness, often due to repetitive motion or pressure.
  • Ingrown Toenail: A common condition where the nail grows into the surrounding skin, causing pain, redness, and swelling.
  • Morton's Neuroma: A condition where a nerve between the toes becomes compressed, causing pain, numbness, and tingling in the big toe.

Do Not Miss Diagnoses

  • Infection (Cellulitis or Abscess): Bacterial infections can cause severe pain, redness, swelling, and warmth in the big toe, requiring prompt antibiotic treatment.
  • Deep Vein Thrombosis (DVT): Although less common, DVT can cause pain and swelling in the leg, including the big toe, and requires urgent medical attention to prevent pulmonary embolism.
  • Diabetic Neuropathy: Nerve damage due to diabetes can cause numbness, tingling, and pain in the feet, including the big toe.

Rare Diagnoses

  • Rheumatoid Arthritis: An autoimmune disorder that can cause pain, swelling, and stiffness in the joints, including the big toe.
  • Psoriatic Arthritis: A condition that combines psoriasis with joint inflammation, potentially affecting the big toe.
  • Tuberculosis of the Bone (Ostearticular TB): A rare infection that can cause pain, swelling, and destruction of the bone and joint in the big toe.
  • Erythromelalgia: A rare disorder that causes burning pain, heat, and redness in the hands and feet, including the big toe.

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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