Gout, with a section on ocular disease in the gouty

by Llewellyn J. Llewellyn

Gout in the Heel

In some instances the first manifestations of gout occur in the heel, while in others the sheath of the neighbouring tendo Achillis is the part first invaded. Probably there is no region of the foot in which there exist more pitfalls, and doubly careful should we be before concluding that any painful or inflammatory condition thereof is one of “gout.”

Referred Pain.—Pain in the heel affords many loopholes for misinterpretation. It may, as Sir James Paget pointed out many years ago, be symptomatic of a renal calculus. In my own experience it is sometimes complained of by the subjects of internal hæmorrhoids, the pain waxing and waning with the variations in the rectal trouble, and only disappearing permanently when the piles have been radically treated. It is, again, a symptom sometimes complained of by the victims of enlarged prostate.