Question
Recently I have had severe pain and swelling in my left foot around the big toe area. An x-ray confirmed a diagnosis of osteoarthritis of the MTP joint of the big toe. What exactly does that mean? Also last year something similar happened to my right foot and I was diagnosed with gout. I took medication for the gout and it went. Can both of these conditions combine to cause this present ailment?
Answer
The MTP joint is the metatarsophalangeal joint, which refers to the joint between the first metatarsal bone and the first phalanx of the big toe. Put simply, that is the joint at the base of the big toe where the toe is joined to the foot. Osteoarthritis means that arthritic changes have taken place in the joint and it is possible that these changes could be gout related. Gout leads to the accumulation of uric acid crystals in the MTP joint and these crystals can trigger the familiar picture of acute inflammation giving rise to a swollen and tender big toe. Over time repeated attacks can lead to more permanent changes in the joint. You should discuss this matter further with your GP to establish if there is a causal relationship between the gout and the osteoarthritis in your specific case. Sometimes it may be necessary to take medication on an ongoing basis to prevent attacks of gout. Since your GP is more familiar with your overall medical history he or she would be the best person to advise if such treatment was advisable for you.