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How can lumps under the toe caused by uric acid crystals be identified?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10707 Questions
Question
I have been asking about a bump under the big toe.
I would like to confirm this is caused by gout.
Fish consumption has been large.
1. f it is caused by uric acid crystals, what is the best procedure to identify them?
2. s a biopsy necessary?
3. I understand Ia prescription of ibuprofen for 2 weeks has been used to cure this..
What would be the dialy dose( times per day) and what strength for each dose?
Tue, 5 Jun 2018 in Bones, Muscles and Joints
 
 
Answered by Dr. Praveen Tayal 1 hour later
Brief Answer:
Serum uric acid levels will detect.

Detailed Answer:
Hello,
Thanks for posting your query.
1. To identify that the lump is due to uric acid crystals you need to get your serum uric acid levels checked.
The lump is actually an inflammation due to crystals. If the serum uric acid levels are high then the synovial fluid will also have high levels of uric acid.
2. No need for a biopsy.
3. We have to use a combination of medications to relieve the inflammation and help the body clear the uric acid. These medications include allopurinol, prednisone, indomethacin or colchicine. In patients who have persistent pain we often use prednisone for 3 to 5 days and patients do well. Only ibuprofen will reduce the pain not the actual problem. Do consult an orthopedician for proper prescriptions. Self medication can be harmful.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by
 
Follow-up: How can lumps under the toe caused by uric acid crystals be identified? 35 minutes later
Another patient had this diagnosis and treated with Ibuprofen and it was cured in 2 weeks in the U.S. could you do further research on the use of Ibuprofen
 
 
Answered by Dr. Praveen Tayal 10 hours later
Brief Answer:
Depends on severity of illness.

Detailed Answer:
Hello.
Thanks for writing again.
Ibuprofen is a mild anti inflammatory. The response depends on the severity of illness also. You can start with 400mg thrice a day afer meals and see if it cures.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by
 
Follow-up: How can lumps under the toe caused by uric acid crystals be identified? 3 hours later
Can you or anyone on the medical team:

Write a prescription for medicine?
Write a prescription to have blood tests done?

It will be used in the U.S.A.
Thanks
 
 
Answered by Dr. Praveen Tayal 28 minutes later
Brief Answer:
Online prescriptions are not legal.

Detailed Answer:
I am sorry we currently have no legal support to prescribe medicines online. The scripts that an online physician writes are not accepted at the local pharmacy. It is not yet recognized by the XXXXXXX Telemedicine association norms. This is because any pharmacy should enter the physician license number and a valid prescription in person before dispensing the drugs.

Regards.

Above answer was peer-reviewed by
 
Follow-up: How can lumps under the toe caused by uric acid crystals be identified? 10 hours later
What about for lab blood tests?

Would you be able to write one for uric acid serum levels and I will see how the labs respond.
Thanks
 
 
Answered by Dr. Praveen Tayal 42 minutes later
Brief Answer:
Online prescriptions are not allowed.

Detailed Answer:
You can show a print out of this transcript to the lab and see if they can do the test. We are legally bound not to write any kind of prescriptions online.
Regards.
Above answer was peer-reviewed by
 
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