The difference between a bunion and a gouty stone lies in the cause of its development, the patient’s uric acid level and the results of imaging studies. 1. Pathogenesis: Gout stones are crystals formed by the deposition of uric acid salts, mostly seen in patients with gout and hyperuricemia; bunion is a foot deformity caused by excessive inclination of the thumb and inversion of the first metatarsal bone, mostly caused by bad shoe-wearing habits, heredity and aging. 2. Patient’s uric acid level: gout stones are usually found in patients with gout and hyperuricemia, so the blood uric acid level of patients with gout stones is usually higher than the upper limit of the normal reference value; bunions and uric acid metabolism have not been found to be significantly linked, and usually do not have an elevated blood uric acid level. 3. Imaging: Gout stones can be seen in the joints through imaging tests such as CT or X-ray, and dislocation or deformity of the 1st metatarsophalangeal joint can be seen in bunions through CT or X-ray. The differential diagnosis between gout stones and bunions should be made by a medical professional, and patients are advised to go to orthopedics and rheumatology departments of regular hospitals for further diagnosis and treatment.