Foot tendon involvment in gout

NewsBot · Jan 25, 2013

Members do not see these Ads. Sign Up.
Tendon involvement in the feet of patients with gout: a dual-energy CT study.
Dalbeth N, Kalluru R, Aati O, Home E, Doyle AJ et al,
Ann Rheum Dis (2013) 13(1):199.

Objectives To examine the frequency and patterns of monosodium urate (MSU) crystal deposition in tendons and ligaments in patients with gout using dual-energy CT (DECT).

Methods Ninety-two patients with tophaceous gout had DECT scanning of both feet. Two readers scored the DECT scans for MSU crystal deposition at 20 tendon/ligament sites and 42 bone sites (total 1840 tendon/ligament sites and 3864 bone sites).

Results MSU crystal deposition was observed by both readers in 199/1840 (10.8%) tendon/ligament sites and in 399/3864 (10.3%) bone sites (p=0.60). The Achilles tendon was the most commonly involved tendon/ligament site (39.1% of all Achilles tendons), followed by the peroneal tendons (18.1%). Tibialis anterior and the extensor tendons were involved less commonly (7.6–10.3%), and the other flexor tendons, plantar fascia and deltoid ligaments were rarely involved (<5%) (p<0.0001 between sites). Involvement of the enthesis alone was more common in the Achilles tendon (OR (95% CI) 74.5 (4.4 to 1264), p<0.0001), as was any involvement of the enthesis (OR (95% CI) 6.8 (3.6 to 13.0), p<0.0001).

Conclusions Tendons are commonly affected by MSU crystal deposition in patients with tophaceous gout. The patterns of MSU crystal deposition suggest that biomechanical strain or other local factors may contribute to deposition of MSU crystals.
Click to expand...

Admin2 · Aug 19, 2016

Related Threads:
Other threads tagged with gout
Achilles tendonitis due to gout
The latest on gout
Poor footwear in gout
Biomechanical characteristics of foot disease in chronic gout
Gout can affect the nose

NewsBot · Aug 19, 2016

Hyperuricemia in Tendons.
Andia I, Abate M
Adv Exp Med Biol. 2016;920:123-32. doi: 10.1007/978-3-319-33943-6_11

Hyperuricemia, particularly gout, and the immune inflammatory response are highly integrated. Both, long standing hyperuricemia and monosodium urate (MSU) crystal deposition can challenge tendon homeostasis because of their potential to cause inflammation to the host. Knowledge is emerging from clinical imaging research depicting where MSU crystals deposit, including patellar tendon, triceps and quadriceps tendons. Remarkably, subclinical tendon inflammation and damage are also present in asymptomatic hyperuricemia. Monosodium urate crystals act as danger activating molecular patterns (DAMPs), activating the inflammasome and inducing the secretion of IL-1beta, a key mediator of the inflammatory response. The crucial role of IL-1beta in driving the inflammatory events during gout attacks is supported by the clinical efficacy of IL-1beta blockade. Some data implicating IL-1beta as an initiator of tendinopathy exist, but the link between hyperuricemia and the development of tendinopathy remains to be validated. Further knowledge about the interactions of uric acid with both innate immune and tendon cells, and their consequences may help to determine if there is a subclass of hyperuricemic-tendinopathy.
Click to expand...

NewsBot · Jun 8, 2020

WHAT IS LOWER EXTREMITY ENTHESEAL INVOLVEMENT IN ACUTE GOUT ATTACK? AN ULTRASOUND-STUDY
H. Cao et al
Scientific Abstracts

Background: Articular involvement in acute gout attack is extremely common and mainly characterized by arthritis, which are usually transient, severe, reversible and well responsive to treatment. The involvement of tendons and entheses in lower extremity in monosodium urate-related disease through US (ultrasound) assessment have been described 1,2. US findings in gout raising the hypothesis that entheseal involvement could be a missing target in the clinical evaluation of gout patients.

Objectives: To evaluate by ultrasound (US) the frequency and characteristics of lower extremity entheseal involvement in acute gout attack patients.

Methods: US assessment were performed by independent rheumatologist on 31 patients with acute gout attack. Presence of lower extremity entheseal involvement were evaluated by grey-scale (GS) and power Doppler (PD). US assessment contain quadriceps, patellar and Achilles tendons, and plantar fascia entheses according to the OMERACT definitions.

Results: US revealed one or more abnormalities in at least one enthesis in 22 out of 31 gout patients (71.0%) and 47 out of 310 entheses (15.2%). Among the affected entheses, the patellar insertion of quadriceps tendon was most commonly involved (57.4%) during acute gout attack, followed by the calcaneal insertion of the Achilles tendon (17.0%) and distal insertion of the patellar tendon (14.9%). The proximal insertion of the patellar tendon and calcaneal insertion of the plantar fascia were involved in 8.5% and 2.1%, respectively. Bone erosions and osteophytes were found in affected entheses (10.6% and 25.5%, respectively).

Conclusion: Our study identifies that lower extremity entheseal involvement is a missing target in the evaluation of patients with acute gout attack. US plays a key role in the assessment of both clinical and subclinical enthesitis in gout patients.
Click to expand...

NewsBot · Jul 5, 2021

Entheseal involvement of the lower extremities in gout: an ultrasonographic descriptive observational study
Guanhua Xu et al
Clin Rheumatol. 2021 Jun 22

Objective: The aim of this study was to explore the prevalence and distribution of lower extremity entheseal abnormities by musculoskeletal ultrasound (US) in a cohort of gout patients, taking spondyloarthritis (SpA) patients and asymptomatic hyperuricemia (HUA) patients as controls.

Method: One hundred participants with gout, fifty patients with SpA, and twenty-nine patients with asymptomatic HUA were recruited. US was used to assess the bilateral quadriceps, patellar and Achilles tendons, and plantar fascia entheses according to the Outcome Measures in Rheumatology (OMERACT) definitions.

Results: The US examination revealed the presence of one or more abnormalities in at least one enthesis in 45 out of 100 subjects (45.0%) and 152 out of 1000 entheses (15.2%) in the gout patients. Among the affected entheses, the patellar insertion of the quadriceps tendon was the most commonly involved area (38.0% in the gout patients versus 48.0% in the SpA patients with at least one pathological US finding, p = 0.241). There were no significant group differences in entheseal power Doppler (PD) signals, bone erosion, or enthesophytes. The patients with lower limb entheseal involvement in the gout group had an older age, longer disease duration, higher percentage of chronic tophaceous gout, and higher levels of inflammatory biomarkers of the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Multivariate logistic regression analysis revealed that age (OR = 1.052, p = 0.001) and the ESR (OR = 1.023, p = 0.028) were correlated with lower limb enthesopathy in gout patients. In the subgroup analysis of gout patients without active inflammation, age (OR = 1.119, p = 0.001) and serum uric acid (UA, OR = 1.012, p = 0.002) were correlated with lower limb enthesopathy in gout.

Conclusion: Lower extremity entheseal involvement might be neglected but should be considered as an important element in the evaluation of gout patients. Enthesopathy most frequently involves in the patellar insertion of the quadriceps tendon and is characterized by entheseal hypoechogenicity and/or thickening. Key Points • Lower extremity enthesopathy might be neglected as an important element in gout. • Enthesopathy is most frequently involved in the patellar insertion of the quadriceps tendon in gout. • Age and ESR are correlated with lower limb enthesopathy in gout patients.
Click to expand...

NewsBot · Apr 11, 2023

A Hospital-Based Cross-Sectional Study of
Patients With Plantar Fasciitis: Is Hyperuricemia
Screening Needed?
Shikha Yadav , Nitish Khandelwal , Saumen K. Nath , Sanjay Rai
Course

Background and aim
Generally, asymptomatic hyperuricemia is considered a benign metabolic abnormality with little clinical
significance in the absence of gout or renal calculus. However, its clinical association with plantar fasciitis is
still not known and is a subject of interest. The study aims to investigate the association between
asymptomatic hyperuricemia and plantar fasciitis in otherwise healthy patients.
Materials and methods
A cross-sectional study was performed, which included 284 patients aged 21-65 years with plantar fasciitis
and without any comorbidities between February 2020 and November 2022. One hundred and fifty patients
with hyperuricemia who attended the endocrinology and medicine outpatient department without heel pain
were included as a control group. Serum uric acid levels were assessed in all cases. Student’s t-test,
correlation tests, and multiple linear regression were used to ascertain the association between uric acid
levels and plantar fasciitis. Statistical analyses were conducted using IBM SPSS Statistics for Windows,
Version 19.0 (Released 2010; IBM Corp., Armonk, New York, United States).
Results
Among the 284 patients, 189 were female (66.5%) and 95 were male (33.4%). Their mean age was 43 ± 9 years
(range: 21-65 years). The p-values of the duration of symptoms, visual analog scale for pain (VAS), and foot
function index (FFI) total score were p = 0.061, p = 0.068, and p < 0.001, respectively. The mean uric acid
levels were 7.6 ± 1.5 mg/dL in males and 7.3 ± 1.3 mg/dL in females in the sample group, and 8.3 ± 1.8 mg/dL
in males and 8.1 ± 1.5 mg/dL in females in the control group. According to a Pearson correlation analysis,
there was no correlation between serum uric acid level and BMI, VAS, duration of symptoms, FFI pain,
disability sub-scores, or FFI total score.
Conclusion
Although asymptomatic hyperuricemia is a common metabolic abnormality, the present study did not find
any significant association between it and plantar fasciitis. Therefore, we can conclude that routine
screening for asymptomatic hyperuricemia is not recommended in plantar fasciitis.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Achilles Tendon and Femoral Cartilage Thickness in Flatfoot

Stiffening the human foot with a biomimetic exotendon

Tendon transfer in foot drop

Association of Cavovarus Foot Alignment With Peroneal Tendon Tears

Foot Orthoses for posterior tibial tendon dysfunction

foot tendons

Under foot near heel pain after surgery for posterior tibial tendon dysfunction

Share This Page