The association between gout and radiographic hand, knee and foot osteoarthritis: a cross-sectional study
Megan Bevis1, Michelle Marshall2, Trishna Rathod2
1Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK. meganbevis@hotmail.com.
Insights
Gout, a common inflammatory arthritis, showed no overall association with osteoarthritis (OA). However, individuals with gout were more likely to have small joint OA and less likely to have large joint OA.
Area of Science:
- Rheumatology
- Epidemiology
- Osteoarthritis Research
Background:
- Gout is the most prevalent inflammatory arthritis, typically affecting peripheral joints.
- The distribution of gout, sparing axial joints, is not fully understood.
- Osteoarthritis (OA) is hypothesized to be a key factor due to shared risk factors with gout.
Purpose of the Study:
- To investigate the association between gout and radiographic osteoarthritis (OA).
Main Methods:
- A cross-sectional study nested within three observational cohorts of individuals aged ≥ 50 years.
- Participants with gout identified via primary care records were matched with controls.
- Radiographic OA presence and severity were assessed using validated atlases and analyzed with conditional logistic regression.
Main Results:
- No statistically significant association was found between gout and overall radiographic OA in the hand, knee, or foot.
- Individuals with gout showed increased odds for nodal hand OA and moderate to severe hand OA.
- Gout patients had increased odds for foot OA but decreased odds for knee OA (tibiofemoral and patellofemoral).
Conclusions:
- No direct association was found between gout and radiographic osteoarthritis.
- Gout patients demonstrated a tendency towards small joint OA.
- Gout patients appeared less likely to develop large joint OA.
Background:
Gout 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).
Methods:
A 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.
Results:
Fifty-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.
Conclusion:
There 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.
