December 10, 2017 at 8:21 pm #6107
Ken BellParticipantŦallars: Ŧ 0.81Rank: Carer
I have had a few gout attacks over the course of time.
But recently after a chest infection, I was woken with pains on top of my foot below my toes and behind my ankle.Then after about a week or so the side of my toe flared up. But the naproxen didn’t help much?
Could this be tendinitis or gout?
December 13, 2017 at 2:12 am #6127
That’s not much information to go on. But I’ll have a stab at answering “could this be tendinitis or gout?”
So, I’ll guess 20% chance of tendinitis and 80% chance of gout. But, if you leave it long enough without controlling your uric acid, gout will cause tendinitis. Then, you’ll have both.
December 13, 2017 at 3:57 pm #6144
Jean ClyneParticipantŦallars: Ŧ 42.06Rank: Researcher
I had Achilles tendinitis for years with thickening along sides of tendon just above the heel, would sometimes bother me a bit, but several months after going on allopurinol, the chronic thickening completely disappeared, is still gone, after having for 20 yrs plus, so I would think it has to be related, too much of a coincidence I would think. Never thought about it being related to gout.
December 14, 2017 at 11:09 am #6149
That’s really interesting Jean. The “thickening” was almost certainly uric acid crystal deposits.
In future, I guess we will have routine body scans for suspected gout sufferers. Then that will show where uric acid deposits are situated around the body. It’s exciting DECT technology. But, it’s mostly limited to research facilities or expensive clinics at the moment.
So, we’re going to have to wait for easy access to DECT technology. But when it comes, it will be easy to differentiate between tendinitis mimicking gout. Or tendinitis caused by gout.
December 14, 2017 at 4:04 pm #6150
There is a strong association between gout and tendinitis that is only recently well described in the medical literature. Particularly in the knee and tendons of the quadriceps, high uric acid can lead to substantial inflammation and pain. Reduction of uric acid does lead to improvement.
On a personal note, I have experienced a similar pain in the knees, which is now much improved as a result of gout management.
If you are interested, I can send some recent references.
December 15, 2017 at 6:53 am #6151
Yes please, Brad!
I’m always interested in medical references. Especially when they help explain little known aspects of gout.
But I ask that you check first to see if I’ve already mentioned them. So please search for the study title in the gout search box near the top of every page.
Also, when you post the references, I’d love to know what you find interesting about them.
Thanks for helping fellow gout sufferers.
December 16, 2017 at 6:21 pm #6154
The first article is a study of hyper uricemic gout patients compared to runners and OA sufferers. It very clearly shows the high incidence of Uric acid deposits in the tendons. This can be found in: Clin. Rheumatol., 2016 vol. 35(8) pp. 2039-2044 – “Tendon involvement in patients with gout: an ultrasound study of prevalence”
December 18, 2017 at 12:04 pm #6181
I’ve listed this for updating my related review of Tendon involvement in the feet of patients with gout: a dual-energy CT study. Then I noticed that suggestion box needs a good clearout. So, I’ll do that, then I’ll list the second report, and add it to the library.
December 16, 2017 at 6:31 pm #6155
A second article that shows the high incedence of tendon involved uric acid deposition and the clinical utility of dual energy CT is: Rev Bras Reumatol Engl Ed, 2017 vol. 57(1) pp. 64-72 “Relevant aspects of imaging in the diagnosis and management of gout”
While most MDs won’t have access to this imaging technology, it still shows they need to be aware of the high impact of gout – and the need to exclude high UA as part of any diagnosis. Seems MDs on both sides of the Atlantic are often missing this point!
December 17, 2017 at 5:28 pm #6160
Jean ClyneParticipantŦallars: Ŧ 42.06Rank: Researcher
Where do I find these, or does a Google search bring them up? Thanks for the info.
December 17, 2017 at 5:43 pm #6162
I’m going to respond properly to Brad’s information soon (Thank You, Brad). Hopefully tomorrow, but might be Tuesday. I will add one report to the gout library. The second report is mainly relevant to Ultrasonic Experts. But the conclusion is important:
Tendon involvement in the lower limbs in gout is very frequent,
particularly at the patellar tendon [kneecap-shin tendon], and UltraSound possesses good sensitivity and specificity for detecting intra-tendinous
tophi [uric acid crystals deposited within tendons].
January 4, 2018 at 11:55 am #6310
Tim RickettsParticipantŦallars: Ŧ 0.57Rank: Carer
Great thanks for this I just posted I am having an attack in my ankle and the rest of my leg gets very sore when I walk it definitely feels like tendons / ligaments I have to stop every few yards for the pain to subside. I’m sure they are also inflamed I didn’t know if it could be related but now I see it probably is.
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