Foot pain, impairment, and disability in patients with acute gout flares: A prospective observational study

Objective To evaluate the impact of acute gout on foot pain, impairment, and disability. Methods. 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. Results. 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. Conclusion. 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.