Tibialis anterior tendon rupture in gout—Case report and literature review

Jerome, J. Terrence Jose; Varghese, Mathew; Sankaran, Balu; Thomas, Simon; Thirumagal, S.K.

doi:10.1016/j.fas.2007.12.001

Cited by 43 publications

(24 citation statements)

References 15 publications

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“…Eversion and inversion motions of the foot, which involve the peroneal and tibialis posterior muscles, are also important throughout the gait cycle, particularly for their contribution to shock absorption and stability [21]. Although the impact that MSU deposition in these ankle structures has on muscle strength remains unclear, several case studies investigating tendon ruptures of the ankle and foot in the gout populations have suggested that the presence of tophi reduces the tensile capacity of tendons [22][23][24]. Furthermore, the infiltration of tophi into muscle tissues may potentially reduce the functional cross-sectional muscle area (i.e.…”

Section: Discussionmentioning

confidence: 99%

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

Stewart

Mawston

Davidtz

et al. 2016

Clinical Biomechanics

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Foot and ankle muscle strength in people with gout: a two-arm cross-sectional study, Clinical Biomechanics (2015Biomechanics ( ), doi: 10.1016Biomechanics ( /j.clinbiomech.2015 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT ABSTRACTBackground Foot and ankle structures are the most commonly affected in people with gout.However, the effect of gout on foot and ankle muscle strength is not well understood. The primary aim of this study was to determine whether differences exist in foot and ankle muscle strength for ankle plantarflexion, dorsiflexion, inversion and eversion between people with gout and age-and sex-matched controls. The secondary aim was to determine whether foot and ankle muscle strength was correlated with foot pain and disability.Methods Peak isokinetic concentric muscle torque was measured for ankle plantarflexion, dorsiflexion, eversion and inversion in 20 participants with gout and 20 matched controls at two testing velocities (30°/s and 120°/s) using a Biodex dynamometer. Foot pain and disability was measured using the Manchester Foot Pain and Disability Index (MFPDI).Findings Participants with gout demonstrated reduced muscle strength at both the 30°/s and 120°/s testing velocities for plantarflexion, inversion and eversion (p<0.05). People with gout also displayed a reduced plantarflexion-to-dorsiflexion strength ratio at both 30 o /s and 120 o /s (p<0.05). Foot pain and disability was higher in people with gout (p<0.0001) and MFPDI scores were inversely correlated with plantarflexion and inversion muscle strength at the 30°/s testing velocity, and plantarflexion, inversion and eversion muscle strength at the 120°/s testing velocity (all p<0.05).Interpretation People with gout have reduced foot and ankle muscle strength and experience greater foot pain and disability compared to controls. Foot and ankle strength reductions are strongly associated with increased foot pain and disability in people with gout.

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Section: Discussionmentioning

confidence: 99%

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

Stewart

Mawston

Davidtz

et al. 2016

Clinical Biomechanics

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“…On the feet, particularly overlying areas of joint deformity and on weight‐bearing areas, these ulcerated tophaceous gouty lesions can become encapsulated in hyperkeratosis, increasing the risk of further tissue breakdown and delayed healing . Data from the UK provide some insight into the presentation patterns of foot ulceration in rheumatoid arthritis (RA) and the impact on health‐related quality of life (HRQL) , but the clinical characteristics of wounds in affected gout patients are poorly defined . Furthermore, while foot involvement in gout has been linked to foot pain, impairment and disability , there has been limited research to elucidate the added effect of ulceration on foot pain, impairment, disability and HRQL in patients already living with gout.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of foot ulceration in people with chronic gout

Rome

Erikson

Otene

et al. 2014

International Wound Journal

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Gout is the most common form of inflammatory arthritis and it has an affliction to the foot. Foot involvement in gout has been linked to foot pain, impairment and disability. There has been limited research on the effect of ulceration on foot pain, impairment, disability and health-related quality of life in patients already living with gout. The aim of the study was to describe the wound characteristics and the effect on foot pain, disability and health-related quality of life in patients with foot ulceration associated with gout. Participants were recruited from rheumatology clinics in Auckland, New Zealand. All the current foot ulceration sites and wound characteristics were recorded using the TIME wound assessment tool. The outcome measures included general pain, patient global assessment scale, foot pain, disability and impairment. Participants completed the Cardiff Wound Impact Schedule to assess the effect of ulcers on health-related quality of life. Sensory loss, vibrational thresholds and ankle brachial pressure index were collated to assess for lower limb arterial disease. Six participants were predominantly older men with a long duration of gout, high rates of obesity and co-morbidities such as hypertension, hyperlipidaemia, diabetes and cardiovascular disease. The mean (SD) duration of the foot ulcers was 4 (2) months. The majority of foot ulcers observed were 0·5 cm(2) or smaller superficial thickness with surrounding callus. Partial thickness and full-thickness ulcers were also observed. Two patients presented with ulcers on multiple sites. There was only one case of infection. Gouty tophi were evident in most of the wounds. The dorsal aspect of the third toe was found to ulcerate in most cases. Moderate scores of foot pain, disability, impairment and health-related quality of life were observed. Most participants wore shoes deemed as poor. Foot ulceration in gout is chronic and multiple ulcers can occur with the potential of leading to delayed wound healing, infection and a reduced quality of life. Poor footwear may contribute to the development and delayed healing of ulceration in people with gout.

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“…Acute rupture of the tibialis anterior tendon is quite rare and traumatic (8)(9)(10)(11), and spontaneous ruptures due to gout, systemic lupus erythematosus, rheumatoid arthritis, diabetes mellitus, and psoriasis have been reported (12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%