What condition is indicated by a 55-year-old man with a swollen big toe and a history of moderate alcohol use?

What condition is indicated by a 55-year-old man with a swollen big toe and a history of moderate alcohol use?

• A. Septic arthritis
• B. Osteoarthritis
• C. Gout
• D. Interdigital neuroma

Answer: (C)

The presentation of a swollen big toe in a 55-year-old man with a history of moderate alcohol use is highly indicative of gout. Gout is a type of inflammatory arthritis that occurs due to elevated levels of uric acid in the blood, leading to the formation of urate crystals in the joints, most commonly affecting the big toe, known as podagra. Alcohol consumption, especially beer, can increase uric acid levels and precipitate gout attacks. In contrast, septic arthritis typically presents with significant pain, fever, and an acute onset of swelling, often with systemic signs of infection, which is not mentioned in this case. Osteoarthritis generally presents with gradual onset pain and swelling, particularly in weight-bearing joints, and is more common in older populations but is unlikely to cause acute swelling localized to a specific joint. Interdigital neuroma, often presenting with pain between the toes, particularly the third and fourth webs, does not match the symptoms described here. Therefore, the combination of the patient's age, the specific location of swelling, and the influence of alcohol consumption aligns well with a diagnosis of gout, making it the most appropriate condition in this scenario.

The presentation of a swollen big toe in a 55-year-old man with a history of moderate alcohol use is highly indicative of gout. Gout is a type of inflammatory arthritis that occurs due to elevated levels of uric acid in the blood, leading to the formation of urate crystals in the joints, most commonly affecting the big toe, known as podagra. Alcohol consumption, especially beer, can increase uric acid levels and precipitate gout attacks.

In contrast, septic arthritis typically presents with significant pain, fever, and an acute onset of swelling, often with systemic signs of infection, which is not mentioned in this case. Osteoarthritis generally presents with gradual onset pain and swelling, particularly in weight-bearing joints, and is more common in older populations but is unlikely to cause acute swelling localized to a specific joint. Interdigital neuroma, often presenting with pain between the toes, particularly the third and fourth webs, does not match the symptoms described here.

Therefore, the combination of the patient's age, the specific location of swelling, and the influence of alcohol consumption aligns well with a diagnosis of gout, making it the most appropriate condition in this scenario.