Sudden, severe ankle pain

“I wonder if it’s gout?”, said me as I finished the champagne and reached for a slice of rich frosted cake. [rofl.gif] (looking for the crying in pain emoji).

QUICK, Eat some Duck Liver Pate!

NOT !!

Imagine my surprise when at the ripe age of 24, I rolled out of bed for the first time and thought I’d broken my foot…

Ah, the Rich Man’s Disease. I’ve had it in the foot, ankle, elbow and knee. No fargin’ fun.

Allopurinol can be your friend!

Must be nice…[grin.gif]…not to have. [wow.gif]

You should be able to see a reddened area where the pain is if it is gout. Tends to be very localized.

Yes, this was unusual. Sudden onset at rest, although I had played pickle ball for the first time yesterday, so maybe the side to side motion stirred something up. No pain while I played; onset 5 hours later. No overt signs in the foot; no swelling or redness. Just severe, well-localized pain to the subtalar jointline. Better today, down to a 1/10 pain level versus an 8/10 last night. I needed a ski pole to help me hop to the bathroom last night. Popping ibuprofen all night, Aleve today. I’ll check an X-ray, uric acid, CBC, sed rate and CRP tomorrow.

With a Colcrys chaser

not acutely with a gouty attack, but that or Uloric for prevention.

Literally turning your big toe to stone.

Human petrification.

Sometimes extreme pain like that at first will not necessarily be felt where the problem is. Sometimes it needs to settle down a little before you or the Dr. can find the source. Swore I had excruciating classic plantar fascitis because that’’s where I was feeling it but after a few days found out it was originating in the metatarsal and turned about to be acute morton’s neuroma. Pain was everywhere but there at first. Best wishes.

And serum uric acid as well.

I knock on wood that in over 12 years of daily allopurinol (don’t think I’ve missed a day in that time span!), and paying close attention to always staying well hydrated), I’ve been attack free. It’s a miraculous thing that’s allowed me to eat and drink what I like. And I sure like beer and shellfish!

And red wine, red meat, asparagus and spinach.

Yes, quite typical for gout, which typically comes on in the middle of the night, or early morning hours. You run a somewhat high uric acid level, you overuse a joint, which creates more joint fluid, then as you rest, the joint fluid reabsorbs, and the uric acid concentration in the joint fluid increases to the point where it starts to crystalize, which makes your joint exceedingly unhappy, and causes a remakable amount of inflammation.

Bet it’s the pickleball, not gout. Been living off shellfish from the beach all summer so when my toe started aching was sure it was gout till my uric acid came back low. Probably kitesurfing in the Columbia pounding my forefoot. Had to put a cutout in the insole of my cycling shoe. Cost of doing business.

Just remember that during an acute attack, your measured uric acid level tends to be misleadingly lower than you would usually run. So say you run a level of 8-9 normally, and get an occasional attack. During an acute attack, you might instead get a level of say 6.5. an inexperienced provider might look at that and tell you you can’t have gout because you have a normal level (in our lab for some reason “normal” is listed as up to 8.0!) Wrong.

Good insight John. Never had checked mine before but came back 5.1.

David–at 5.1 you are likely safe. Just an old guy.