From the Research
Injury can predispose a joint to become a site of gout attack, as it creates an environment that promotes urate crystal deposition and precipitation in the damaged tissue. When a joint experiences trauma or injury, it leads to local inflammation, changes in pH, decreased temperature, and altered blood flow in the affected area, making it more susceptible to gout flares 1. This phenomenon is explained by the "deep Koebner phenomenon," which suggests that injury can disrupt joint structures, creating more surface area for crystal formation, and thus increasing the risk of gout attacks in previously injured joints, such as the first metatarsophalangeal joint 1.
Some key points to consider in the management of gout include:
- The importance of protecting joints from injury to reduce the risk of gout attacks in those locations
- Informing healthcare providers about any recent injuries if a new gout flare occurs, as this connection can help with diagnosis and management
- The use of urate-lowering therapies, such as allopurinol and febuxostat, to prevent gout flares, although febuxostat is associated with an increased risk of cardiovascular mortality 2
- The role of lifestyle modifications, including diet and exercise, in preventing gout flares 3
It is essential to note that patients with gout have an increased risk of injury overall, and drug intervention may not lower the risk of injury in these patients 4. Therefore, protecting joints from injury and managing gout flares promptly are crucial in reducing the risk of gout attacks and improving quality of life for patients with this condition.