Auckland University of Technology, Auckland, New Zealand.
Arthritis Care Res (Hoboken). 2012 Mar;64(3):384-8. doi: 10.1002/acr.20670.
To evaluate the impact of acute gout on foot pain, impairment, and disability.
This prospective observational study recruited 20 patients with acute gout flares. Patients were recruited from emergency departments, hospital wards, and rheumatology outpatient clinics throughout Auckland, New Zealand. Patients were recruited at the time of the flare (baseline visit) and then reassessed at a followup visit once the acute flare had resolved 6-8 weeks after the initial assessment. Swollen and tender joint counts, C-reactive protein levels, and serum urate levels were recorded at both visits. General and foot-specific outcome measures were also recorded at each visit, including pain visual analog scale, Health Assessment Questionnaire II, Lower Limb Tasks Questionnaire, and Leeds Foot Impact Scale.
The foot was affected by acute gout in 17 patients (85%). Objective measures of joint inflammation, including swollen and tender joint counts and C-reactive protein levels, significantly improved at the followup visit compared with the baseline visit. At baseline, high levels of foot pain, impairment, and disability were reported. All patient-reported outcome measures of general and foot-specific musculoskeletal function improved at the followup visit compared with the baseline visit. However, pain, impairment, and disability scores did not entirely normalize after resolution of the acute gout flare.
Patients with acute gout flares experience severe foot pain, impairment, and disability. These data provide further support for improved management of gout to prevent the consequences of poorly controlled disease.
评估急性痛风对足部疼痛、功能障碍和残疾的影响。
这是一项前瞻性观察性研究，共纳入 20 例急性痛风发作患者。患者来自新西兰奥克兰的急诊室、病房和风湿病门诊。在痛风发作时（基线就诊时）招募患者，并在初始评估后 6-8 周急性发作缓解时进行随访。在两次就诊时均记录肿胀和压痛关节计数、C 反应蛋白水平和血清尿酸水平。每次就诊时还记录一般和足部特定的结局指标，包括疼痛视觉模拟评分、健康评估问卷 II、下肢任务问卷和利兹足部影响量表。
17 例患者（85%）的足部受到急性痛风影响。与基线就诊时相比，随访就诊时的关节炎症客观指标（包括肿胀和压痛关节计数和 C 反应蛋白水平）显著改善。在基线就诊时，报告足部疼痛、功能障碍和残疾程度较高。与基线就诊时相比，所有一般和足部特定肌肉骨骼功能的患者报告结局指标在随访就诊时均有所改善。然而，在急性痛风发作缓解后，疼痛、功能障碍和残疾评分并未完全恢复正常。
急性痛风发作患者会经历严重的足部疼痛、功能障碍和残疾。这些数据进一步支持改善痛风管理以预防疾病控制不佳的后果。
