WHY would my doctor dismiss gout?

[weeone]

I am at a loss with this pain! Last month, out of the blue, my big toe joint started hurting and I couldn't imagine why as I had not injured it. After four or five days the pain subsided.

Last week it began hurting again. So much so that I was taking Tylenol #3 in order to ease the pain. The joint was swollen, but not terribly so. But it was certainly swollen. The pain got very intense and I finally went to the doctor yesterday.

He had an xray done and said he didn't think it was gout. He said it could be a sore tendon or a bit of osteoarthritis.

When I was searching on line for a reason for this pain, everything led me to gout. But the doctor said no, it wasn't gout, because it would be REALLY red and REALLY swollen and hot.

OK... so it's only somewhat swollen and not red. But the pain is intense. I asked him if maybe the reason it wasn't really swollen was because I was just coming down with it and it wasn't in an advanced stage yet and he said no.

My concern is that I really believe it IS gout but that it's in its beginning stage. So I need to know what others have experienced with their gout first started. Did it start right off being really red, swollen and hot, or did the pain first start with just a bit of swelling and not any redness?

If this is the first beginning of gout, I need to know so i can start some treatment before it gets worse.

[thurstonb]

Hi there

It is quite possible this is gout. It certainly has some of the most common traits of a gout attack. My gout started off with a red, hot and swollen toe like most gout. When my gout had worsened at it got into my ankles it stopped being so typical and it took me a long time to finally get it diagnosed properly. I had the pain but the swelling and heat was not there all the time.

You mention that you think the gout might be in a beginning stage and perhaps this was the reason it wasn't so hot and swollen. Well this is probably wrong in my experience. Gout usually strikes big time when it strikes, and as your gout gets worse the attacks may come more often or they may last longer, but the attack itself is much the same level of pain and swelling whether it's your first attack or your 100th.

Did your doctor get your uric acid levels tested? That would be a pretty good test.

Cheers
Brett

[MAMAB]

Hello Weeone!
I have had problems with foot pain for around years. I have been treated for inflamations, infections, etc. Nothing seemed to help. I finally started checking on the internet for chronic foot pain and low and behold, I came to the conclusion that it was gout and mentioned it to my dr. who didn't think that it was. I was having flare after flare and spent 4 months taking prenisone. It was get better while on the prednisone and then flare back up after I was off of it for a few days. I finally convinced him to order bloodwork to check my uric levels which came back at 8 1/2. He referred me to a rheumotologist who wasn't sure it was gout, as I am a female and gout is rare in females and I didn't fit any other molds. No family history, not a drinker, not overweight, etc. It took a REALLY bad flare to convince him that it was gout. But he is convinced. I am now on colcochine which has helped with the swelling and pain, but I have stomach problems and daily headaches. I have missed so much work due to this and only someone that has had an attack can appreciate the intense pain and loss of the ability to walk. This has taken over my life, but I am hoping I am on the right track. My next step is to start with allpurinol. Please push on getting tested and treated for gout. I can take all the joy from your life very quickly!!

[fit foot]

Gout in the foot or toe does not necessarily need to be VERY swollen, it can be mild, or murmuring. I think you should ask your doctor to carry out a blood test, this may have to be taken a week or so after the gout subsides.

[Ohithurtssomuch]

I get gout in my left big toe joint. The first doc I saw said he knew what gout looks like, he dismissed it being gout. My joint swells a little and turns a little red but hurtssomuch. After 2 yrs later I got a new family doc. I had a flare-up and he had blood work done and my uric acid was high. So you can't go by what it looks like.

[podagra]

Do you have any relatives with gout? Check your uric acid, blood ferritin and serum iron, if uric acid>7, serum iron >130 and ferritin >150 it may be gout, but your immune system may be depressed, so its response is milder than usual.
An inexpensive way to find out is to take brine baths and if the swelling resolves then donate blood every 2 months for a while. If the attacks disappear you have gout. If the pain persists despite the baths and the blood donation you may have a hairline crack, other forms of arthritis, etc,
to see how to take the brine baths check out
http://www.goutonline.net/showthread.php?t=10755

you can also confirm that it's gout, if most of these factors affect you
http://www.goutonline.net/showthread.php?t=10782

Hell, if you drink 2 beers or glasses of red wine and eat oysters and a steak or liver and get an unbearable attack, you'll know it's gout for sure, you can then take the baths, donate blood, etc, if not, look for something else. Tell your doctor that if he doesn't do an aspiration of the joint to discard gout but categorically asserts that it is not gout just by looking at it, you are going to do this and if you get an attack he´ll be responsible.