Abstract
BackgroundGout frequently affects the foot yet relatively little is known about the effects of gout on foot structure, pain and functional ability. This study aimed to describe the impact of gout in a UK primary care population.MethodsA cross-sectional study was nested within an observational cohort study of adults aged ≥50 years with foot pain. Participants with gout were identified through their primary care medical records and each matched on age (±2 years) and gender to four participants without gout. Differences in person-level variables (SF-12 Physical Component Score, Manchester Foot Pain and Disability Index and Short Physical Performance Battery) between gout and non-gout participants were determined using regression models. Differences in foot-level variables (pain regions, skin lesions, deformities, foot posture, and non-weightbearing range of motion) were determined using multi-level regression models. All models were adjusted for body mass index. Means and probabilities with 95% confidence intervals were calculated.ResultsTwenty-six participants with gout were compared to 102 participants without gout (77% male; mean age 66 years, standard deviation 11). Subtalar joint inversion and eversion and 1st metatarsophalangeal joint (MTPJ) dorsiflexion range of motion were significantly lower in the gout participants compared to the non-gout participants. Gout participants were more likely to have mallet toes and less likely to have claw toes compared to non-gout participants. There were no statistically significant differences in person-level variables, foot posture, ankle dorsiflexion range of motion, hallux valgus, pain regions, or skin lesions.ConclusionsNon-weightbearing range of motion at the subtalar joint and 1st MTPJ was reduced in people with gout. Patients with gout who present with chronic foot problems should therefore undergo appropriate clinical assessment of foot structure.
Highlights
Gout frequently affects the foot yet relatively little is known about the effects of gout on foot structure, pain and functional ability
Gout is most common in the small joints, with 43–76% of first episodes occurring in the first metatarsophalangeal joint (MTPJ), and commonly affects the midfoot and ankle joints [2, 3]
Four small cross-sectional studies performed in New Zealand recruited adults with chronic gout from rheumatology clinics and found higher levels of foot-related pain and disability, reduced peak ankle joint angular velocity and slower walking speed with shorter step and stride lengths, reduced range of motion in the 1st MTPJ dorsiflexion, lower peak plantar pressures in the hallux and had higher pressure time integrals in the midfoot compared to participants without gout [4,5,6,7]
Summary
Gout frequently affects the foot yet relatively little is known about the effects of gout on foot structure, pain and functional ability. Gout is most common in the small joints, with 43–76% of first episodes occurring in the first metatarsophalangeal joint (MTPJ), and commonly affects the midfoot and ankle joints [2, 3]. Whilst the predilection of attacks of gout for the foot and ankle is well-recognised, the chronic effects of MSU crystal deposition on foot structure and function have been under-researched. Four small cross-sectional studies performed in New Zealand recruited adults with chronic gout from rheumatology clinics and found higher levels of foot-related pain and disability, reduced peak ankle joint angular velocity and slower walking speed with shorter step and stride lengths, reduced range of motion in the 1st MTPJ dorsiflexion, lower peak plantar pressures in the hallux and had higher pressure time integrals in the midfoot compared to participants without gout [4,5,6,7]. The generalisability of these findings and whether they can be reproduced in a primary care gout population where disease severity is likely to be milder is unknown
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
