Diagnosis
At the beginning of the diagnosis there should be a precise inquiry of the symptoms by the doctor. This may help to identify activities or triggers such as cuts or other small injuries that may have preceded the inflammation. The doctor should also look for any particular strain on the toes caused by work, sport or footwear.
The question of known pre-existing conditions can make you think of gout or rheumatism right at the beginning. Looking at the toe with the inflammation is a further step to assess the color and swelling of the toe as well as the condition of the nail. An ingrown toenail can thus be diagnosed immediately.
Likewise, the inflammation of the nail bed on the toe, primarily due to the redness and swelling with accompanying pain, is a gaze diagnosis which, together with questioning the affected person about possible causes, justifies treatment. In order to identify a responsible pathogen, a smear from the affected toe makes sense. With this method, bacteria, fungi and viruses can be reliably detected and also specifically treated.If mobility is severely restricted and the complaints have existed for a long time, in rare cases an X-ray or magnetic resonance imaging can be ordered to exclude the involvement of bones or tendons.
The diagnosis of gout is made in a similar way, mainly clinically, with the addition of a laboratory chemical component. In addition to the typical, sudden occurrence of the inflammation on the toe as a sign of gout, the doctor will take a blood sample and examine it for certain values. Elevated uric acid levels and inflammation values underline the suspicion.
If there is any doubt, uric acid crystals can be detected directly by a sample from the affected area. The diagnosis of a rheumatological cause is more complicated and should be made by a rheumatologist. The basics here are clinical observations such as stiffness in the toe, inflammation and the infestation of at least one other joint. Laboratory values leading to the diagnosis of rheumatoid arthritis are inflammation values and certain antibodies specific to this type of disease.