Foot pain, impairment, and disability in patients with acute gout flares: A prospective observational study

Abstract

Objective. To evaluate the impact of acute gout on foot pain, impairment, and disability. Methods. This prospective observational study recruited 20 patients with acute gout flares. Patients were recruited from emergency departments, hospital wards, and rheumatology outpatient clinics throughout Auckland, New Zealand. Patients were recruited at the time of the flare (baseline visit) and then reassessed at a followup visit once the acute flare had resolved 6 -8 weeks after the initial assessment. Swollen and tender joint counts, C-reactive protein levels, and serum urate levels were recorded at both visits. General and foot-specific outcome measures were also recorded at each visit, including pain visual analog scale, Health Assessment Questionnaire II, Lower Limb Tasks Questionnaire, and Leeds Foot Impact Scale. Results. The foot was affected by acute gout in 17 patients (85%). Objective measures of joint inflammation, includingswollen and tender joint counts and C-reactive protein levels, significantly improved at the followup visit compared with the baseline visit. At baseline, high levels of foot pain, impairment, and disability were reported. All patient-reported outcome measures of general and foot-specific musculoskeletal function improved at the followup visit compared with the baseline visit. However, pain, impairment, and disability scores did not entirely normalize after resolution of the acute gout flare. Conclusion. Patients with acute gout flares experience severe foot pain, impairment, and disability. These data provide further support for improved management of gout to prevent the consequences of poorly controlled disease.

Foot and ankle muscle strength in people with gout: A two-arm cross-sectional study

“…The findings from the current study are consistent with previous studies which have shown that foot-related pain, disability and impairment are not only features of acute gouty arthritis [9], but also present during intercritical periods [10,11]. None of our gout participants were experiencing symptoms of acute arthritis at the time of the study which highlights the chronicity of foot pain in this population.…”

“…People with gout report difficulty walking and experience high levels of foot pain, disability and impairment [9][10][11][12]. Previous studies have also shown people with gout demonstrate apropulsive gait patterns with reduced walking speed and cadence [10,12].…”

Outcome Measures in Acute Gout: A Systematic Literature Review

“…Sensitivity to change over time has been reported, with effect size in an observational study of acute gout calculated as 1.43 after >1 month following treatment (26). A randomised controlled trial comparing canakinumab with triamcinolone acetonide has not shown between-group discrimination .…”

Foot-related pain and disability and spatiotemporal parameters of gait during self-selected and fast walking speeds in people with gout: A two-arm cross sectional study

“…In the presence of persistent hyperuricaemia, chronic synovitis, tophi and tissue damage may develop [3][4][5]. People with gout report high levels of foot pain and disability [6][7][8] and experience difficulty in carrying out recreational and daily living activities requiring normal lower limb function [6,9]. Furthermore, people with gout rate walking difficulty as a discriminatory feature of the disease [10].…”