<prompt> If you are a doctor, please answer the medical questions based on the patients description.I woke up the other morning Thursday, and on my right hand, the middle knuckle was so swollen I could not use my hand, there does not look like there is any kind of a bite mark, I went to the DR. and had an x-ray done, showed nothing, the doctor thought it might be gout, took blood test, no gout showed up. It itches very much, and is swollen, the swelling is reducing some, but still can t make a fist. thought this was free, sorry to bother you.  <response>: Cellophane You for contacting Chat Doctor. Your symptoms and history is suggestive of allergy from an insect bite. If I were your treating doctor then would advise: levocetirizine one at night for 5 days. montelukast one daily for one month. Research has shown that it decreases the allergic symptoms considerably. Allergic response takes some time to resolve itself. So take medicine and observe. Hopefully it will regress in 5-7 days. Hope this answers your question. If you have additional questions or follow-up questions then please do not hesitate in writing to us. Wishing you good health. 