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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18769
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I have had what at first the doctor thought was gout, which

Resolved Question:

I have had what at first the doctor thought was gout, which I have had before, but as it didn't go I went for an x-ray and blood test. The x-ray showed some wear and tear, so maybe the start of arthritis, the blood test was at the top of normal for gout. I have now had it for 3 months, painkillers make me ill, so can't take them, just paracetamol. It seems to get better, but then it flares up again. Have had the 3 day tablet colchedine, which again made me very ill, but I took it, but the 'gout' didn't go. Then had antibiotics as it looked infected, they did nothing.
As I am hoping to go away on holiday in about 10 days, I am worried I wont be able to walk if it doesn't settle again by then. Is there anything else I can do?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
Hello from JustAnswer.
Which joint is affected by this?
Have you had any fluid withdrawn from this joint for testing?
Which pain killers made you ill?
Are you currently taking any medicine beyond the paracetamol?
Customer: replied 2 years ago.

The joint is the big toe

I have not had any fluid drawn from it

Ibuprofen, as I have IBS, and it gives me stomach pains. Also the Colchedine which I took for a 3 day only course.

Nothing else for the 'gout', but take medication for high blood pressure, hyatus hernia, and IBS

Expert:  Dr. D. Love replied 2 years ago.
Thank you for the additional information.

If there is a large amount of inflammation involving the joint at the base of the toe, it is very likely that it is gout, even if the blood test is completely normal. The best method for confirming the diagnosis of gout would be examination of fluid from an involved joint to look for uric acid crystals. It is not as easy to get fluid from a smaller joint, such as from the toes, so the best test cannot always be done.

If an oral anti-inflammatory medicine cannot be taken and colchicine is ineffective, then the usual next step would be the use of steroidal anti-inflammatory medicines. This can be done as an injection of cortisone-type medicines into the joint or the use of oral prednisone. If the symptoms are more severe, then an injection into the joint would be more often used, but oral prednisone would otherwise be used. Oral prednisone, though, also can cause stomach irritation, so in someone with a sensitive stomach, it also may be better to use an injection into the joint.

If I can provide any further information, please let me know.
Customer: replied 2 years ago.

How long would I have to wait to get the injection? Would this mean seeing my own doctor, waiting for the hospital to give me an appointment, etc.

It's just that I am going away in 10 days time.

Expert:  Dr. D. Love replied 2 years ago.
It would frequently involve seeing a specialist to obtain a joint injection. Some primary care physicians are trained in joint injections, but many prefer to refer to a specialist. It would be appropriate to be seen by your regular doctor. If referral is necessary, then your regular doctor can facilitate getting a timely appointment.
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