Gout: This condition is 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 the metatarsal region. The patient's age and the description of the symptoms make gout a highly plausible diagnosis.

Cellulitis: A bacterial skin infection that can cause redness, swelling, and tenderness, often without a clear history of trauma. Given the patient's symptoms, cellulitis is a possible diagnosis, especially if there's a break in the skin that allowed bacteria to enter.
Bursitis: Inflammation of the fluid-filled sacs (bursae) that cushion bones, tendons, and muscles near joints can cause pain, swelling, and redness. The metatarsal region has several bursae that could become inflamed, leading to these symptoms.
Osteoarthritis: While more commonly associated with joint pain and stiffness, osteoarthritis can also cause swelling and tenderness, especially if there's an acute flare-up or if the patient has been increasing their activity level.

Deep Vein Thrombosis (DVT): Although less common in the foot, DVT can cause swelling, redness, and tenderness. Given the potential for severe consequences if missed (pulmonary embolism), it's crucial to consider DVT, especially in older adults or those with risk factors for thrombosis.
Infection (e.g., abscess, septic arthritis): Any infection in the foot can lead to severe consequences, including the need for surgical intervention or the risk of spreading the infection. Prompt identification and treatment are critical.
Charcot Foot (Neuropathic Arthropathy): Especially in patients with diabetes, Charcot foot can cause significant destruction of the foot's bones and joints, leading to deformity and potential for infection. Early recognition is vital for management.

Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet. While it's less common, it could be considered in the differential diagnosis if other causes are ruled out.
Complex Regional Pain Syndrome (CRPS): A chronic pain condition that most often affects one of the arms, legs, hands, or feet after an injury or trauma. It's rare but could be a consideration if the patient's symptoms persist and other diagnoses are excluded.