Gout and bunion are two extremely different medical conditions that have a set of similar symptoms that might be misleading.
Definition
Gout is a medical condition characterized by excess of uric acid levels in the blood leading to deposition of crystals of uric acid in the joints. It starts with depositions in the great toe followed by other tissues and joints. Gout is also called as “podagra” when it affects the great toe only. Gout is considered as a part of crystal-induced arthritis. Bunions, in contrast, are bony disfigurements of the great toe which can be seen as a mal-alignment of the bone of the great toe. Bunion is seen as outward displacement of the great toe due to genetic causes. Bunions are more commonly seen in females whereas gout is more commonly seen in males.
Gout in X-ray of left foot
Difference in causes
Gout occurs due to an excess of uric acid in the body that fails to be excreted by the kidneys. The exact cause of bunion formation is not known but is strongly linked genetically and ill-fitting footwear and flat feet are known to worsen it.
Difference in symptoms:
In an acute episode of gout, there is redness and pain noted in the great toe along with swelling of the joint which is affected. In bunions, there is presence of bony swelling visible that is often painful while walking but there is absence of swelling and redness. Bunions are extremely painful while walking especially on wearing high heels and small-toed footwear. It is often difficult to find shoes which will be comfortable for a person who has bunion on the feet.
Bunion
Difference in Investigations:
Gout can be diagnosed by performing a simple blood test which measures the serum uric acid levels whereas radiographs are the gold standard to diagnose bunion as the bony growth is visible in the X-ray. Many physicians also perform a suction of fluid from the joints which shows presence of uric acid crystals on microscopy. Aspiration is necessary to judge the severity of the inflammation and the type of crystals caused by gout.
Treatment:
Gout is controlled rapidly by giving anti-inflammatory medicines to control the pain and medicines which will reduce the uric acid levels in the body. Colchicine is a specific drug used to reduce the acute attack of pain in gout. The analgesics and anti-inflammatory medicines will reduce the pain and the inflammation respectively in gout whereas for bunions there is a conservative line of treatment which consists of altering footwear or using orthotics. Orthotics are accommodative padding or splints which will fit the bunion and will give a layer of padding to the bunion, preventing pain. Ice pack, rest and medication to relieve pain are the second line of treatment. For persons who have repeated bunion pain which is persistent despite conservative methods, a podiatric surgeon can perform a minimally invasive surgery to correct the deformity.
Summary:
Gout is a systemic condition characterized by excess uric acid which allows deposition of uric acid crystals in the joints and various other tissues whereas bunion is a toe deformity which involves outward displacement of the bones of the great toe. Gout can be controlled with dietary modifications but bunions can be controlled only by modifying the ill fitting foot wear and adding orthotics like insoles to reduce the pain.