Osteoarthritis may predispose patients to gout

[ar2st]

Osteoarthritis (OA) may trigger the deposit of uric acid crystals in joints, the main cause behind gout.

OA is a very common chronic disorder involving the joints. It is also called degenerative arthritis as it is related to the ageing process. The rubbing of joint surfaces causes wearing away and damage to the constant cartilage, which is the elastic tissue or padding in joints that act as a smooth cushioning material inside joints, and prevents bones from rubbing together. In case of OA, the cartilage becomes rough, flaky and small pieces break off. With time, large sections of cartilage may get worn out completely, leaving the bone ends unprotected so that the rough surfaces rub against each other and cause painful joints. This also makes the joints susceptible to the deposition of uric acid crystals, leading to gout.

To investigate whether patients with gout are more likely to have arthritis, and if the same joints are affected, researchers from the University of Nottingham, UK sent questionnaires to adults aged over 30 years registered with two general practices. The questionnaire assessed a history of gout (doctor diagnosed, or episodes suggestive of acute crystal synovitis) and medication use. Patients who possibly had gout attended for clinical assessment to verify the diagnosis on clinical grounds and assess the distribution of joints affected by acute attacks of gout and OA. A total of 4249 completed questionnaires were returned (32 per cent). From 359 attendees, 164 cases of gout were clinically confirmed. It was found that there was a strong association between the site of acute attacks of gout and the presence of osteoarthritis.

The findings suggest that that the presence of osteoarthritis at an individual joint site predisposes to the formation of urate crystals at that site.