Frequency of erosive arthritis and associated factors in gout patients: a single-center radiological study

There are limited data on radiographic frequency of erosive artrhritis (EA) in gout patients.

To describe the frequency, and associated factors of EA in gout patients.

Adult patients diagnosed with gout according to the 2015 ACR/EULAR Classification Criteria were enrolled from a single tertiary rheumatology center. Medical records were reviewed retrospectively. Anteroposterior foot radiographs were independently evaluated by two rheumatologists. Erosive arthritis was defined as the presence of a cortical break with sclerotic margins and an overhanging edge appearance in at least one metatarsophalangeal joint.

A total of 210 patients were included in study, with a mean age of 57.8 years, and 88.1% were male. Median disease duration was five years. The freqeuncy of tophus was 10.5% (n = 22), and 20% of patients (n = 42) had EA. In EA-positive group, alcohol consumption (p = 0.022), disease duration (p < 0.001), upper extremity joint arthritis (p < 0.001), knee arthritis (p = 0.005), serum urate level (p = 0.029), and the presence of tophus (p < 0.001) were significantly higher. In multivariable regression analysis, disease duration (p < 0.001; OR = .903, 95% CI: .859-.949), alcohol consumption (p < 0.001; OR = 46.361, 95% CI: 10.955-196.204), and the presence of tophus (p = 0.041; OR = 2.693, 95% CI: 1.043-6.953) were identified as potential independent predictive factors of EA.

Our finding of an association between alcohol consumption and EA is particularly striking. Prospective studies using sensitive imaging modalities are needed to further elucidate this relationship.