Final answer:
The given symptoms such as severe joint pain and swelling, particularly in the first metatarsophalangeal joint along with knees and other areas, suggest Gout as the most likely diagnosis. Gout is characterized by the deposition of uric acid crystals in the joints, leading to intense pain and inflammation. This diagnosis is distinct from Rheumatoid Arthritis, which typically presents with symmetrical joint involvement and is a chronic condition.
Step-by-step explanation:
Based on the description of severe joint pain, erythema, warmth, swelling, and tenderness, including the first metatarsophalangeal (MTP) joint, knees, elbows, hands, wrists, ankles, and feet, the most likely diagnosis is Gout. This form of arthritis is caused by the deposition of uric acid crystals within a joint, leading to intense inflammation and pain. Generally, it affects one joint at a time, often starting with the big toe, but it can spread to other joints.
Rheumatoid arthritis (RA) is another possibility, a chronic inflammatory disorder predominantly affecting synovial joints such as the hands, feet, and cervical spine and is usually symmetrical. However, RA involves joint inflammation, cartilage breakdown, and bone damage leading to pain and deformity with characteristic factors such as rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and elevated inflammatory markers like C-reactive protein (CRP).
Despite similarities in symptoms, the acute presentation and the involvement of MTP joints, especially the big toe, are more indicative of Gout than RA. Diagnosis and treatment strategies for gout focus on managing pain, controlling uric acid levels, and modifying diet and lifestyle to prevent further attacks.