Blood tests for uric acid are sometimes influenced by blood levels or some patients have had a prolonged period of elevated uric acid, but this may not be at its highest during a gout attack, so being within the normal range does not necessarily mean that the pain is not caused by gout. Another key point of differentiation between gout and bunions is that gout often causes diffuse swelling around the first metatarsophalangeal joint, whereas bunions often have limited redness and swelling on the inside of the joint.