Thanks for the query to H.C.M.Forum.
Since pain and tenderness present both toes so some systemic disease may be as,
, get in blood for uric acid level , usually this is the most common site of gout .
2 Rheumatoid arthritis
, get in blood for rheumatoid factor
for confirmation as E S R also elevated in this disease .
, however usually large joint involves , but small joints also involves.
In my opinion consult an orthopedic surgeon and get his opinion and treatment as physical examination is very important .
Good luck. Dr. HET