Toe pain and swelling
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| Toe pain and swelling Classification and external resources |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
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Overview
Causes can be as simple as trauma or infection. They can also be rheumatoid arthritis, endocarditis or athlerosclerotic vascular disease. The most common cause/complaint is Gout.
Gout can be so excruciating at times that even the weight of a bed sheet is unbearable.
Differential Diagnosis
In alphabetical order. [1] [1]
- Cholesterol emboli
- Infective endocarditis
- Ingrown toenail
- Pseudogout
- Seronegative spondyloarthropathy
- Septic arthritis
- Trauma
Laboratory Findings
- CBC
- Electrolytes
- BUN / creatinine
- Calcium
- Magnesium
- Phosphorus
- ESR
- [[Blood cultures]
- Lyme titers
- Iron (psudogout)
- Synovial fluid analysis
Imaging Findings
- Radiographs
- Fractures
- Osteomyelitis signs
- Psoriatic arthritis
Other Diagnostic Studies
- Synovial fluid analysis
- Look for an infection, crystals, inflammation
- Gram stain, polarized light microscopy
- Cell counts should result in a WBC count less than 50,000/ml if inflamed
- Cell counts should result in a WBC count greater than 50,000/ml in infectious arthritis
Treatment
Acute Pharmacotherapies
Gout
- NSAID's
- Colchicine
Chronic Pharmacotherapies
Gout
- Urate lowering agents
- Colchicine
Ingrown toenails
- Warm soaks
- Toe nail removal
Pseudogout
- NSAIDs
- Corticosteroids
- Colchicine
Reiter's Syndrome
- Prednisone
- Local steroid injection
- Sulfasalazine
- Methotrexate
- Indomethacin
Septic arthritis
- Ceftriaxone -> gram negative infections
- Cefazolin -> gram positive (add gentamicin for psudomonal infections)
References
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .


