Differential Diagnosis for Big Toe Pain
- Single most likely diagnosis
- Gout: This is often the first consideration for big toe pain, especially if it's sudden, severe, and accompanied by redness and swelling. Gout is a form of inflammatory arthritis characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, most often in the big toe.
- Other Likely diagnoses
- Osteoarthritis: Wear and tear on the joint can cause pain and stiffness in the big toe, especially in older adults.
- Bunions: A bony bump at the base of the big toe can cause pain, especially if it rubs against shoes.
- Ingrown toenail: A common condition where the nail grows into the surrounding skin, causing pain, redness, and swelling.
- Sesamoiditis: Inflammation of the tendons surrounding the sesamoid bones under the big toe can cause pain, especially with activities that involve pushing off the ground.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteomyelitis: A bone infection that can cause severe pain, redness, and swelling, and can lead to serious complications if not treated promptly.
- Septic arthritis: A joint infection that can cause severe pain, redness, and swelling, and can lead to serious complications if not treated promptly.
- Deep vein thrombosis (DVT): A blood clot in the deep veins of the leg can cause pain and swelling, and can lead to a life-threatening pulmonary embolism if not treated promptly.
- Rare diagnoses
- Rheumatoid arthritis: An autoimmune disorder that can cause pain and stiffness in multiple joints, including the big toe.
- Psoriatic arthritis: A type of arthritis that occurs in people with psoriasis, causing pain and stiffness in multiple joints, including the big toe.
- Neuroma: A growth of nerve tissue that can cause pain, numbness, and tingling in the big toe.
- Charcot foot: A condition that causes nerve damage and can lead to severe pain, redness, and swelling in the foot, especially in people with diabetes.