Tendinitis mimicking Gout? Or tendinitis caused by gout?

Stopping Gout Together Forums Help My Gout! The Gout Forum Tendinitis mimicking Gout? Or tendinitis caused by gout?

This topic contains 11 replies, has 5 voices, and was last updated by  Tim Ricketts 10 months, 2 weeks ago.

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  • #6107

    Ken Bell
    Participant
    Ŧallars: Ŧ 0.11


    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?

    regards ken


    Tendinitis or Gout photo

    Tendinitis mimicking gout? Or tendinitis caused by uric acid crystals?

  • #6127

    Keith Taylor
    Keymaster
    Ŧallars: Ŧ 1170.15

    Hi Ken,

    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.

  • #6144

    Jean Clyne
    Participant
    Ŧallars: Ŧ 41.56

    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.

    • #6149

      Keith Taylor
      Keymaster
      Ŧallars: Ŧ 1170.15


      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.

  • #6150

    Brad Keck
    Participant
    Ŧallars: Ŧ 4.61

    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.

    Brad

    • #6151

      Keith Taylor
      Keymaster
      Ŧallars: Ŧ 1170.15

      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.

  • #6154

    Brad Keck
    Participant
    Ŧallars: Ŧ 4.61

    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”

  • #6155

    Brad Keck
    Participant
    Ŧallars: Ŧ 4.61

    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!

  • #6160

    Jean Clyne
    Participant
    Ŧallars: Ŧ 41.56

    Where do I find these, or does a Google search bring them up? Thanks for the info.

    • #6162

      Keith Taylor
      Keymaster
      Ŧallars: Ŧ 1170.15

      Hi Jean,

      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].

  • #6310

    Tim Ricketts
    Participant
    Ŧallars: Ŧ -0.03

    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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