This condition should be considered as a possible gouty condition if it is not due to the stiffness of the anterior portion of the leather shoes.

On the diagnosis of gout:

1 there are specific urate crystals in the joint fluid, or

2 gout stones containing urate crystals confirmed by chemical methods or polarized light microscopy, or

3 with the following 12 (clinical, laboratory, X-ray manifestations) in 6

① acute arthritis attack > 1

②Inflammatory response peaks within 1?d

③Monoarticular arthritic attack

④Redness of the joints can be seen

⑤Pain or swelling in the first metatarsophalangeal joint

⑥Unilateral involvement of the first metatarsophalangeal joint

⑦Unilateral tarsometatarsal joint involvement

⑧Suspected gout stone

⑨Hyperuricemia

⑩Unsymmetrical intraarticular swelling (asymmetric swelling within the joints)

⑩No Symmetrical intra-articular swelling (x-ray confirmed)

(11) Subcortical cysts of bone without bone erosion (x-ray confirmed)

(12) Negative microbiological cultures of joint fluids during arthritic attacks

Common attack sites in gout (see the following diagram):

Question Analysis

You can determine, based on the description of gout and the diagrams above, that yourself whether it is due to a crush injury from a leather shoe or gout.