Gout: This is a common condition that often presents with sudden, severe pain in the big toe, especially in men. The absence of other symptoms and a negative X-ray for fracture make gout a likely diagnosis.

Osteoarthritis: Wear and tear on the joint can cause pain in the big toe, especially if the patient has a history of repetitive stress or injury to the area.
Bursitis: Inflammation of the fluid-filled sacs (bursae) that cushion the joints can cause pain and swelling in the big toe.
Tendinitis: Inflammation of the tendons that connect muscles to bones can cause pain and stiffness in the big toe.
Ingrown Toenail: A common condition where the nail grows into the surrounding skin, causing pain, redness, and swelling.

Osteomyelitis: A bone infection that can cause severe pain, redness, and swelling, and can lead to serious complications if left untreated.
Cellulitis: A bacterial skin infection that can cause pain, redness, and swelling, and can spread to other parts of the body if left untreated.
Deep Vein Thrombosis (DVT): A blood clot in the deep veins of the leg that can cause pain, swelling, and warmth in the affected area, and can lead to life-threatening complications if left untreated.

Rheumatoid Arthritis: An autoimmune disorder that can cause pain, stiffness, and swelling in the joints, including the big toe.
Psoriatic Arthritis: A type of arthritis that occurs in people with psoriasis, causing pain, stiffness, and swelling in the joints.
Sesamoiditis: Inflammation of the sesamoid bones, which are small bones embedded in tendons, can cause pain and stiffness in the big toe.
Neuroma: A benign growth of nerve tissue that can cause pain, numbness, and tingling in the big toe.