Toed

Musculoskeletal System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This middle aged man has presented with acute inflammation of his right big toe; the differential diagnosis includes local pathologies such as septic arthritis, cellulitis, gout and pseudogout, as well as systemic rheumatologic conditions.\n\nExamination shows that the metatarsal joint appears to mainly affected; considering his age and gender, this is a classical presentation of gout - making this the most likely diagnosis.\n\nThat said, the other diseases listed above cannot be excluded on clinical grounds alone; targeted investigations are essential.\n\nIn this regard, joint fluid analysis is the most informative test; the presence of uric acid crystals confirms the clinical diagnosis, while at the same time ruling out the other pathologies. T"}]}

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