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Why do I have pain and swelling in my big toe?

Q: I am a 37 years old man who met with an accident recently and got a little cut above the big toe joint on the left foot. The doctor said that there was no bony injury. But after 10 days, I started having swelling and pain . However, there was injury on the right side at the time of the accident. I consulted the doctor again and he said there is no problem with the bone and suggested a blood test for uric acid, which was found to be 7.0. The doctor prescribed Zyloric 100 mg twice a day. Is this medication correct? I have a family history of gout.

A:The normal upper range of plasma uric acid is up to 8 mg in males; beyond that it is diagnostic of acute gouty arthritis. Hence yours is a borderline case. If there is still swelling and pain then one should take an anti-inflammatory drug such as Diclomol (diclofenac with paracetamol), one tablet thrice daily with food for 5-7 days. Zyloric (allopurinol) is useful in preventing future attacks of gout but does not give immediate relief. Hence one can take both Diclomol for about 5-7 days and then continue with Zyloric. After about a month uric acid should be measured again to see if it has fallen below 5mg.

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