Case study: A case of debilitating gout in the 1st metatarsophalangeal joint

Tanner, Natalie; Diaper, Ross; King, Matthew R.; Metcalfe, Stuart

doi:10.1016/j.foot.2014.11.004

Cited by 2 publications

(2 citation statements)

References 42 publications

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“…The foot and ankle is a very common area for gouty involvement, with the first metatarsophalangeal joint (first MTPJ) being the most common site at 85% to 90% of all cases. 33 Surgical intervention is indicated for severe disease that has resulted in joint destruction, active concomitant infection, deformity, and/or gait dysfunction.…”

Section: Foot/anklementioning

confidence: 99%

“…Joint destructive features and hallux valgus deformity are often concurrent in this patient population 36 The primary indications for surgical treatment of the first MTPJ are destructive arthropathy resulting in pain or deformity, a tophus that creates difficulty with shoewear, or superinfection of a gouty tophus. 33 In cases of a painful tophus without underlying bony pathology, tophus excision alone may be sufficient, but patients should be counseled regarding the risk of wound complications, recurrence, and infection. 37 If a large soft-tissue defect is anticipated after tophus removal, consideration can be given to soft-tissue rearrangement with skin graft and/or flap coverage.…”

Section: Lower Extremitymentioning

confidence: 99%

See 1 more Smart Citation

Orthopaedic Management of Gout

Cohen-Rosenblum¹,

Somogyi²,

Hynes³

et al. 2022

JAAOS Glob Res Rev

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Gout is characterized by the deposition of monosodium urate crystals in patients with chronically elevated blood levels of uric acid. It is the most common form of inflammatory arthritis in the United States and is often comorbid with hypertension, obesity, and chronic kidney disease. Initial presentation is usually an acutely warm, swollen joint, most commonly the first metatarsophalangeal joint, but a variety of locations may be affected. The main treatment for gout is medical management of acute inflammation and chronic uric acid levels, but surgical treatment may be indicated in cases of damage to the surrounding soft tissue, concomitant septic arthritis, symptomatic cartilage loss, or neurologic deficits. Based on the literature to date, gout does not seem to independently affect outcomes after total hip, knee, and ankle arthroplasty, but associated comorbidities affecting outcomes in these patients should be considered.

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Section: Foot/anklementioning

confidence: 99%