musculoskeletal and connective tissue disorders
Metatarsophalangeal Joint Pain
Diagnosis of Metatarsophalangeal Joint Pain
Mainly clinical evaluation Exclusion of infection or arthropathy if signs of inflammation Metatarsophalangeal joint pain can usually be differentiated from Interdigital Neuroma by the absence of burning, numbness, tingling, and interspace pain, but these symptoms may result from joint inflammation; if so, palpation can help with differentiation. Monarticular warmth, erythema, and swelling indicate infection until proven otherwise, although gout is more likely. When warmth, redness, and swelling involve multiple joints, evaluation for a systemic cause of joint inflammation (eg, gout, rheumatoid arthritis, psoriatic arthritis, viral-associated arthritis, enteropathic arthritis), including laboratory tests for systemic rheumatic diseases (eg, anticyclic citrullinated peptide [anti-CCP] antibody, rheumatoid factor [RF], erythrocyte sedimentation rate, C-reactive protein), is indicated. Imaging of the foot with color Doppler ultrasonography may be helpful to detect synovial proliferation, inflammation, and possible early erosions or findings suggestive of deposition of monosodium urate ("double contrast sign"). 