Are joints affected by gout also affected by osteoarthritis?
Ann Rheum Dis. 2007 Feb 6;
Roddy E, Zhang W, Doherty M
OBJECTIVES: To determine whether joints affected by gout are also affected by osteoarthritis (OA).
METHODS: A postal questionnaire was sent to all adults aged over 30 years registered with two general practices. The questionnaire assessed a history of gout (doctor diagnosed, or episodes suggestive of acute crystal synovitis) and medication use. Possible cases of gout attended for clinical assessment in order to verify the diagnosis on clinical grounds and assess the distribution of joints affected by acute attacks of gout and OA. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated between the history of an acute attack of gout and the presence of OA at an individual joint adjusting for age, gender, BMI and prior diuretic use in a binary logistic regression model.
RESULTS: 4249 completed questionnaires were returned (32%). From 359 attendees, 164 clinically confirmed cases of gout were identified. A highly significant association existed between the site of acute attacks of gout and the presence of OA (aOR 7.94; 95% CI 6.27, 10.05). Analysis at individual joint sites revealed a significant association at the 1st MTPJ (aOR 2.06; 95% CI 1.28, 3.30), mid-foot (aOR 2.85; 95% CI 1.34, 6.03), knee (aOR 3.07; 95% CI 1.05, 8.96) and distal interphalangeal joints (aOR 12.67; 95% CI 1.46, 109.91).
CONCLUSION: Acute attacks of gout at individual joint sites are associated with the presence of clinically assessed OA at that joint suggesting that OA may predispose to the localised deposition of MSU crystals.