Haw can a trainee GP miss gout?

My last gout attack was two years ago, it happened again while overseas? Why?.

A trainee GP sent me for an x-ray and pain killing medication. The next day I rang the surgery and asked for gout medication and it is getting better now.

All I am trying to understand why is it difficult if identify goutt when it is in the middle top foot not on a big toe?

5 Replies

Maybe he or she was being thorough, concerned there may be infection there (septic arthritis) & prescribed pain relief until the cause was confirmed? Both that & gout would be obvious from x ray though & if you have previous attacks on your record that would seem to be a likely cause. I think gout only affects joint ends & of course all your toes are joints so it stands to reason any one of them could be afflicted but if it's at the top, not textbook, that could be a reason why imaging was ordered.

Does your diet change when you go abroad? If you're eating more of a particular food, fresh seafood, steak, something along those lines, more than you would eat at home, something like that, or do you drink more (I know, that old chestnut!), but a combination of the two could bring on an attack possibly? Seems odd it's happened again whilst you're away.

On the plus side I'm pleased what's been prescribed is working. My f-i-l seems to react positively to what he's prescribed, the name eludes me just now.



Thank you for your response. Now I understand why? in the UK when I have red hot big toe I was given antibiotics on two or three times before (septic arthritis) . I have an appointment on Thursday, I am not sure in the imaging will be there for us to discuss the problem or only a report fro the hospital X-ray department. The trip to India was a Hindu Temple trip therefore I was on veg food and not drinking. I drank plenty of water each day.

In the last two years I was careful on my food and drinks intake!

I need to understand this problem and take proper medication on my next trip to avoid pain and walking difficulties.


It might be worth looking into whether you were regularly eating veg high in purinol, not all are low. That may be helpful anyway, work out if your diet contains purinol rich foods or if it's relative to previous attacks. Long distance trips, when you can't get up often enough to walk round, could add to the risk of an attack. I remembered the med, alopurinol, he's prescribed it for attacks & my h tells me he takes it a week before a flight regardless as recommended by his GP.

I hope you can pinpoint what causes an attack, it must be frustrating not to say painful.


Thank you. Will give an update after Thursday's appointment.


My GP is referring me to a foot specialist. Only time will tell!


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