Acute Gout Flares Result in Foot Pain, Impairment, and Disability

April 30, 2012

Gout flares cause disabling foot pain that may never go away completely.

Acute gout flares are associated with severe foot pain, impairment, and disability. These symptoms improve after treatment but do not normalize entirely.

Rome and colleagues recruited 20 patients with acute gout flares from emergency departments, hospital wards, and rheumatology outpatient clinics. Patients were reevaluated after 6 to 8 weeks once the flare had resolved. Swollen and tender joint counts, C-reactive protein (CRP) levels, and serum urate levels were recorded at both visits. General and foot-specific outcome measures-pain visual analog scale, Health Assessment Questionnaire II (HAQ-II), Lower Limb Tasks Questionnaire, and Leeds Foot Impact Scale-also were recorded.

Significant improvement was seen in clinical measures of acute gout between the visits in patient global assessment, HAQ-II scores, swollen joint count, tender joint count, and CRP level. Serum urate level did not change significantly between the visits. The use of NSAIDs, the most common treatment for acute gout at the baseline visit, was reduced significantly at the follow-up visit. The rate of foot pain, high at the time of the gout flare, was reduced by 73% at follow-up.

The authors noted that their findings provide further support for improved management of gout to prevent the consequences of poorly controlled disease.