Petty Helen R, Rathod-Mistry Trishna, Menz Hylton B, Roddy Edward
1Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, and Keele Clinical Trials Unit, David Weatherall Building, Keele University, Staffordshire, ST5 5BG UK.
2School of Allied Health, La Trobe University, Bundoora, Victoria 3086 Australia.
J Foot Ankle Res. 2019 Jan 25;12:8. doi: 10.1186/s13047-019-0317-2. eCollection 2019.
Gout frequently affects the foot yet relatively little is known about the effects of gout on foot structure, pain and functional ability. This study aimed to describe the impact of gout in a UK primary care population.
A cross-sectional study was nested within an observational cohort study of adults aged ≥50 years with foot pain. Participants with gout were identified through their primary care medical records and each matched on age (±2 years) and gender to four participants without gout. Differences in person-level variables (SF-12 Physical Component Score, Manchester Foot Pain and Disability Index and Short Physical Performance Battery) between gout and non-gout participants were determined using regression models. Differences in foot-level variables (pain regions, skin lesions, deformities, foot posture, and non-weightbearing range of motion) were determined using multi-level regression models. All models were adjusted for body mass index. Means and probabilities with 95% confidence intervals were calculated.
Twenty-six participants with gout were compared to 102 participants without gout (77% male; mean age 66 years, standard deviation 11). Subtalar joint inversion and eversion and 1st metatarsophalangeal joint (MTPJ) dorsiflexion range of motion were significantly lower in the gout participants compared to the non-gout participants. Gout participants were more likely to have mallet toes and less likely to have claw toes compared to non-gout participants. There were no statistically significant differences in person-level variables, foot posture, ankle dorsiflexion range of motion, hallux valgus, pain regions, or skin lesions.
Non-weightbearing range of motion at the subtalar joint and 1st MTPJ was reduced in people with gout. Patients with gout who present with chronic foot problems should therefore undergo appropriate clinical assessment of foot structure.
痛风常累及足部，但对于痛风对足部结构、疼痛及功能能力的影响却知之甚少。本研究旨在描述痛风对英国基层医疗人群的影响。
一项横断面研究嵌套于一项针对≥50岁足部疼痛成年人的观察性队列研究中。通过基层医疗病历识别出痛风患者，并为每位痛风患者按年龄（±2岁）和性别匹配4名非痛风患者。使用回归模型确定痛风患者与非痛风患者在个体水平变量（SF-12身体成分评分、曼彻斯特足部疼痛与残疾指数以及简短体能表现量表）上的差异。使用多水平回归模型确定足部水平变量（疼痛区域、皮肤病变、畸形、足部姿势以及非负重活动范围）的差异。所有模型均对体重指数进行了校正。计算了95%置信区间的均值和概率。
将26名痛风患者与102名非痛风患者进行了比较（男性占77%；平均年龄66岁，标准差11）。与非痛风患者相比，痛风患者的距下关节内翻和外翻以及第一跖趾关节背屈活动范围显著更低。与非痛风患者相比，痛风患者更易出现槌状趾，而爪形趾的发生率更低。在个体水平变量、足部姿势、踝关节背屈活动范围、拇外翻、疼痛区域或皮肤病变方面，未发现统计学上的显著差异。
痛风患者的距下关节和第一跖趾关节非负重活动范围减小。因此，出现慢性足部问题的痛风患者应接受足部结构的适当临床评估。
