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01-12-2011 | Review | Uitgave 1/2011 Open Access

Journal of Foot and Ankle Research 1/2011

Revisiting the pathogenesis of podagra: why does gout target the foot?

Tijdschrift:
Journal of Foot and Ankle Research > Uitgave 1/2011
Auteur:
Edward Roddy
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (doi:10.​1186/​1757-1146-4-13) contains supplementary material, which is available to authorized users.

Competing interests

The author declares that they have no competing interests.

Abstract

This invited paper provides a summary of a keynote lecture delivered at the 2011 Australasian Podiatry Conference. Gout is the most prevalent inflammatory arthropathy. It displays a striking predilection to affect the first metatarsophalangeal joint as well as joints within the mid-foot and ankle. A number of factors are known to reduce urate solubility and enhance nucleation of monosodium urate crystals including decreased temperature, lower pH and physical shock, all of which may be particularly relevant to crystal deposition in the foot. An association has also been proposed between monosodium urate crystal deposition and osteoarthritis, which also targets the first metatarsophalangeal joint. Cadaveric, clinical and radiographic studies indicate that monosodium urate crystals more readily deposit in osteoarthritic cartilage. Transient intra-articular hyperuricaemia and precipitation of monosodium urate crystals is thought to follow overnight resolution of synovial effusion within the osteoarthritic first metatarsophalangeal joint. The proclivity of gout for the first metatarsophalangeal joint is likely to be multi-factorial in origin, arising from the unique combination of the susceptibility of the joint to osteoarthritis and other determinants of urate solubility and crystal nucleation such as temperature and minor physical trauma which are particularly relevant to the foot.

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Extra materiaal
Authors’ original file for figure 1
13047_2011_339_MOESM1_ESM.pdf
Authors’ original file for figure 2
13047_2011_339_MOESM2_ESM.pdf
Authors’ original file for figure 3
13047_2011_339_MOESM3_ESM.pdf
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