Most people would associate gout with the big toe joint pain or the ankle , knee joint redness or swelling.

Some patients will present with Achilles tendon insertional pain, where the Achilles insert into the heel bone in the back of the heel.

How to tell the difference? There are not clear cut way but history will help, such as pain coming on all of a sudden overnight, severe pain and redness as well as lack of history of trauma to the Achilles tendon. Pain all of a sudden overnight or after a big protein fueled meal would be a significant part of the history that may point the diagnosis more towards gout.

Treatment for such would include steroid pack, immobilization with a boot as well as anti-inflammatories. Gout typically will respond quickly to steroid packs, the immobilization would prevent any Achilles tendon ruptures during the recovery. Typically, we do not inject into the Achilles insertion but rather the sheath of the Achilles tendon in order to avoid spontaneous ruptures. It is a balancing act in dealing with this condition. Lab work such as uric acid level may be of help but low uric acid or normal levels would not exclude the diagnosis of gout but does help to rule out chronic gout where the patient has consistent elevated uric acid levels.

When in doubt, immobilize and seek help at the Family Foot and Leg Center, PA for yourself or your loved ones. 239 430 3668

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