Related Experiment Video
Updated: Feb 18, 2026
An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
Tophus size is associated with hallux valgus deformity in gout
Camille Blandin1,2, Marine Forien1,2, Anais Gardette1,2
1Sorbonne Paris Cité, UFR de Médecine, Université Paris Diderot, Paris, France.
Insights
Hallux valgus (HV) is more common in gout patients. Larger tophi, indicative of urate deposition, correlate with HV severity, suggesting early gout treatment may prevent foot deformities.
Area of Science:
- Rheumatology
- Orthopedics
- Podiatry
Background:
- Hallux valgus (HV) and gout are common conditions affecting the first metatarsophalangeal joint (MTP1).
- Both conditions cause pain and deformation, impacting joint function.
Purpose of the Study:
- To investigate the correlation between tophus size and HV characteristics in patients with gout.
- To understand the relationship between urate deposition and foot deformities.
Main Methods:
- A case-control study comparing gout patients with controls (spondyloarthritis without crystal disease).
- Radiographic and ultrasound (US) assessments were performed by blinded operators.
- US identified gout features (double contour sign, tophus); HV was defined by specific angular measurements (hallux abductus [HA] angle ≥20°, intermetatarsal [IM] angle ≥10°).
Main Results:
- HV was significantly more prevalent in gout patients (62%) compared to controls (37%).
- A positive correlation was observed between the size of US-detected tophi and both IM (r=0.3381) and HA (r=0.2344) angles.
- These correlations were significant regardless of HV status.
Conclusions:
- The study confirms a high prevalence of HV in gout patients.
- Tophus size correlates with the degree of HV, indicating a link between urate deposition and foot deformity.
- Initiating early urate-lowering therapy for gout may help prevent or reduce the severity of HV.
Objective:
Hallux valgus (HV) and gout are common pathologies of the first metatarsophalangeal joint (MTP1) leading to pain and deformation. In this study, we aimed to determine the correlation between tophus size and characteristics of HV in gouty patients.
Methods:
In this case-control study, we included patients with gout (the presence of monosodium urate crystals in synovial fluid) and control patients with spondyloarthritis, without crystal disease disorders. Radiographic assessment and ultrasound (US) assessment were performed by two blinded operators. US features of gout (double contour [DC] sign and/or tophus) were collected. HV was defined by hallux abductus (HA) angle ≥20° and/or intermetatarsal angle (IM) ≥10°. Correlation between US findings and HV angles was estimated by Spearman correlation coefficient.
Results:
We included 56 gouty patients (87.5% males, mean age of 63.9 ± 12.2 years) and 41 control patients (90% males, mean age of 59.0 ± 12.8 years). HV was more frequent in patients with gout than controls (62% vs 37%, P = .0007). Regardless of HV status, correlations were found between the size of US tophi and IM (r = .3381, P = .003) and HA angles (r = .2344, P = .043).
Conclusions:
Our results confirm a high prevalence of HV in gouty patients. We also observed a correlation between the size of the US tophus and the angles defining HV, which suggests a link between urate deposition load and HV. Early urate-lowering therapy for gout could limit the occurrence of HV.
