Just saw my husband’s foot and I’m panicking. It’s huge and red and he says it feels like it’s on fire. Emergency care is hours away. What is this?

While infections and injuries can also cause swelling and redness, gout has distinct characteristics. Unlike infections, gout rarely causes fever or chills unless there’s an accompanying infection (which is a medical emergency). Injuries often have a clear precipitating event, like a fall or twist, whereas gout attacks can occur spontaneously, often overnight.

The symmetry of the swelling is also a clue; gout usually affects one joint, most commonly the big toe, rather than multiple joints. If your husband hasn’t experienced any trauma to the foot and he’s not exhibiting systemic signs of infection, there’s a good chance you’re dealing with a gout attack.

The big toe is often the first joint to be affected by gout because of its lower temperature compared to other parts of the body. Uric acid is less soluble at cooler temperatures, which means crystals are more likely to form in the toe. Additionally, the big toe endures significant pressure and stress from walking and standing, making it more vulnerable to an attack.