RHEUMATOLOGY

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RHEUMATOID ARTHRITIS

Presents with pain and swelling in the forefoot (ball of the foot) without any history of trauma usually raises suspicion of RA particularly if accompanied by joint pain elsewhere in the body. 
The feet are involved earlier and more frequently than the hands in RA cases. 
Joint erosions are diagnostic and indicate the need for second-line drug management.

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GOUT

Gout generally affects middle-aged men but not uncommon in women after menopause. In some cases, swelling of the fingers and the presence of gouty tophi are diagnostic. The condition is caused by dietary excess including excessive alcohol consumption.

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PSORIATIC ARTHRITIS

Psoriatic arthritis affects the joints of the hands, feet and spine. Skin involvement may be hidden. Psoriatic arthritis can present as very destructive arthritis.