Ulcerated gout masquerading as a non healing diabetic foot ulcer: a case series

Gout has made a significant resurgence in recent years affecting people with type 2 diabetes, hypertension and chronic kidney disease. Although uncommon, ulcerated gout should be considered in patients presenting with a non healing diabetic foot ulcer, particularly if the first hallux is involved with bony involvement seen on imaging studies. A prior history of gout or hyperuricaemia can be helpful. Early recognition of ulcerated gout masquerading as diabetic foot infection/osteomyelitis and prompt institution of aggressive medical treatment can preserve joint integrity and aid prompt healing. Surgical treatment is usually reserved for intolerable pain, recurrent ulcerations, infection and joint destruction. Our case series highlights the importance of recognising ulcerated gout in patients presenting with a hot swollen foot mimicking osteomyelitis. A high index of suspicion led to revision of diagnosis and subsequent appropriate management with rapid and satisfactory resolution of ulcerated gout.