The association between gout and radiographic hand, knee and foot osteoarthritis: a cross-sectional studyReportar como inadecuado

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BMC Musculoskeletal Disorders

, 17:169

Epidemiology of musculoskeletal disorders


BackgroundGout is the most common type of inflammatory arthritis and is largely managed in primary care. It classically affects the first metatarsophalangeal joint and distal peripheral joints, whereas the axial joints are typically spared. The reason for this particular distribution is not well understood, however, it has been suggested that osteoarthritis OA may be the key factor.

One hypothesis is that there is an association between the disease states of gout and OA as the conditions share common risk factors. The objective of this study was to determine whether there is an association between gout and radiographic osteoarthritis OA.

MethodsA cross-sectional study was nested within three observational cohorts of people aged ≥50 years with hand, knee and foot pain. Participants with gout were identified through primary care medical records and each matched by age and gender to four individuals without gout. The presence and severity of radiographic OA were scored using validated atlases. Conditional logistic regression models were used to examine associations between gout and the presence, frequency and severity of radiographic OA at the hand, knee and foot and adjusted for BMI, diuretic use and site of joint pain.

ResultsFifty-three people with gout were compared to 211 matched subjects without gout. No statistically significant associations were observed between gout and radiographic hand, knee or foot OA. However, individuals with gout had increased odds of having nodal hand OA aOR 1.46; 95 % CI 0.61, 3.50, ≥8 hand joints with moderate to severe OA aOR 3.57; 95 %CI 0.62, 20.45, foot OA aOR 2.16; 95 % CI 0.66, 7.06, ≥3 foot joints affected aOR 4.00; 95 % CI 0.99, 16.10 and ≥1 foot joints with severe OA aOR 1.46; 95 % CI 0.54, 3.94 but decreased odds of tibiofemoral aOR 0.44; 95 % CI 0.15, 1.29 or patellofemoral aOR 0.70; 95 % CI 0.22, 2.22 OA in either knee.

ConclusionThere was no association between gout and radiographic OA, however, people with gout appeared to be more likely to have small joint OA and less likely to have large joint OA.

KeywordsCrystal arthropathies Osteoarthritis Epidemiology Radiology Primary care rheumatology AbbreviationsBMIbody mass index

CASFclinical assessment study of the foot

CASHAclinical assessment study of the hand

CASKclinical assessment study of the knee


CIconfidence interval


CMJcuneo-metatarsal joint

CPPDcalcium pyrophosphate dihydrate

DIPdistal interphalangeal

GPgeneral practitioner

IPJinterphalangeal joint

JSNjoint space narrowing

KandLkellgren and lawrence


MSUmonosodium urate

MTPJmetatarsophalangeal joint

N1CJnavicular-first cuneiform


ORodds ratio



PIPperipheral interphalangeal


TNJtalo-navicular joint


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Autor: Megan Bevis - Michelle Marshall - Trishna Rathod - Edward Roddy


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