Premium
Tophus size is associated with hallux valgus deformity in gout
Author(s) -
Blandin Camille,
Forien Marine,
Gardette Anais,
Palazzo Elisabeth,
Dieudé Philippe,
Ottaviani Sébastien
Publication year - 2018
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12862
Subject(s) - tophus , gout , medicine , valgus , valgus deformity , orthopedic surgery , radiography , rheumatology , deformity , orthodontics , uric acid , surgery , hyperuricemia
Objective Hallux valgus ( HV ) and gout are common pathologies of the first metatarsophalangeal joint ( MTP 1) leading to pain and deformation. In this study, we aimed to determine the correlation between tophus size and characteristics of HV in gouty patients. Methods In this case‐control study, we included patients with gout (the presence of monosodium urate crystals in synovial fluid) and control patients with spondyloarthritis, without crystal disease disorders. Radiographic assessment and ultrasound ( US ) assessment were performed by two blinded operators. US features of gout (double contour [ DC ] sign and/or tophus) were collected. HV was defined by hallux abductus ( HA ) angle ≥20° and/or intermetatarsal angle ( IM ) ≥10°. Correlation between US findings and HV angles was estimated by Spearman correlation coefficient. Results We included 56 gouty patients (87.5% males, mean age of 63.9 ± 12.2 years) and 41 control patients (90% males, mean age of 59.0 ± 12.8 years). HV was more frequent in patients with gout than controls (62% vs 37%, P = .0007). Regardless of HV status, correlations were found between the size of US tophi and IM ( r = .3381, P = .003) and HA angles ( r = .2344, P = .043). Conclusions Our results confirm a high prevalence of HV in gouty patients. We also observed a correlation between the size of the US tophus and the angles defining HV , which suggests a link between urate deposition load and HV . Early urate‐lowering therapy for gout could limit the occurrence of HV .