From the Guidelines
Yes, gout can occur in the Metacarpophalangeal (MCP) joints, although it is less common than in other joints such as the big toe joint (first metatarsophalangeal joint). Gout is a type of arthritis caused by elevated uric acid levels in the blood, which form sharp, needle-like crystals that deposit in joints, causing intense pain, swelling, redness, and warmth 1. The diagnosis of gout is supported by suggestive features such as monoarticular involvement of a joint, rapid onset of severe pain and swelling, erythema, and associated cardiovascular diseases and hyperuricaemia 1.
Key Points to Consider
- Gout can occur in any joint in the body, including the MCP joints 1
- Proper diagnosis through joint fluid analysis is important to differentiate gout from other forms of arthritis like rheumatoid arthritis 1
- Treatment typically includes medications like colchicine, NSAIDs, or corticosteroids for acute attacks, and urate-lowering therapies such as allopurinol or febuxostat for long-term management 1
- Lifestyle modifications including weight loss, limiting alcohol, avoiding high-purine foods, and staying well-hydrated can help prevent future attacks 1
Important Considerations for Diagnosis and Treatment
- The American College of Physicians recommends using synovial fluid analysis when clinical judgment indicates that diagnostic testing is necessary in patients with possible acute gout 1
- The European League Against Rheumatism evidence-based recommendations for the diagnosis of gout suggest searching for crystals in synovial fluid or tophus aspirates in every person with suspected gout 1
From the Research
Gout in Metacarpophalangeal (MCP) Joints
- Gout can occur in various joints, including the Metacarpophalangeal (MCP) joints, as evidenced by the deposition of monosodium urate crystals in these joints 2.
- A study published in 2007 found that ultrasonography (US) can detect deposition of MSU crystals on cartilaginous surfaces, as well as tophaceous material and typical erosions, in MCP joints 2.
- The presence of gout in MCP joints is characterized by specific diagnostic features, including a hyperechoic, irregular band over the superficial margin of the articular cartilage, and hypoechoic to hyperechoic, inhomogeneous material surrounded by a small anechoic rim, representing tophaceous material 2.
- While the majority of gout cases affect the first metatarsophalangeal joint, gout can also affect other joints, including the MCP joints, as part of its clinical presentation 3, 4, 5.