PSEUDOPODAGRA: Differential Diagnosis of Gout

Several conditions may give rise to diagnostic difficulty by mimicking the painful swollen big toe which is so characteristic of gout. They include soft-tissue infection, pyrophosphate arthropathy, acute calcific periarthritis, palindromic rheumatism, ankylosing spondylitis, Reiter's disease and other post-infective arthropathies, psoriatic arthropathy, sarcoidosis, osteoarthrosis and mechanical problems, infective arthritis, arthritis of pancreatic disorders, non-disease, and psychogenic rheumatism. The diagnosis of gout should be based on identification of urate crystals, since raised serum-uric-acid levels and response to colchicine are unreliable tests.