title: Presence of gout is associated with increased prevalence and severity of knee osteoarthritis among older men: results of a pilot study.
abstract: BACKGROUND
  Gout and osteoarthritis (OA) are the most prevalent arthritides, but their relationship is neither well established nor well understood.
  
  
  OBJECTIVE
  We assessed whether a diagnosis of gout or asymptomatic hyperuricemia (AH) is associated with increased prevalence/severity of knee OA.
  
  
  METHODS
  One hundred nineteen male patients aged 55 to 85 years were sequentially enrolled from the primary care clinics of an urban Veterans Affairs hospital, assessed and categorized into 3 groups: gout (American College of Rheumatology Classification Criteria), AH (serum urate ≥6.8 mg/dL, no gout), and control (serum urate <6.8 mg/dL, no gout). Twenty-five patients from each group subsequently underwent formal assessment of knee OA presence and severity (American College of Rheumatology Clinical/Radiographic Criteria, Kellgren-Lawrence grade). Musculoskeletal ultrasound was used to detect monosodium urate deposition at the knees and first metatarsophalangeal joints.
  
  
  RESULTS
  The study showed 68.0% of gout, 52.0% of AH, and 28.0% of age-matched control subjects had knee OA (gout vs control, P = 0.017). Odds ratio for knee OA in gout versus control subjects was 5.46 prior to and 3.80 after adjusting for body mass index. Gout subjects also had higher Kellgren-Lawrence grades than did the control subjects (P = 0.001). Subjects with sonographically detected monosodium urate crystal deposition on cartilage were more likely to have OA than those without (60.0 vs 27.5%, P = 0.037), with crystal deposition at the first metatarsophalangeal joints correlating most closely with OA knee involvement.
  
  
  CONCLUSIONS
  Knee OA was more prevalent in gout patients versus control subjects and intermediate in AH. Knee OA was more severe in gout patients versus control subjects.
authors.affiliation: From the *Division of Rheumatology, New York University School of Medicine/NYU Langone Medical Center; †Department of Medicine, New York Harbor Health Care System New York Campus of the US Department of Veterans Affairs; ‡Department of Radiology and §Division of General Internal Medicine, New York University School of Medicine/NYU Langone Medical Center, New York, NY; and ∥Department of Pediatrics, Biostatistics Section, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Rennie G
authors.initials: RG
authors.lastname: Howard
authors.forename: Jonathan
authors.initials: J
authors.lastname: Samuels
authors.forename: Soterios
authors.initials: S
authors.lastname: Gyftopoulos
authors.forename: Svetlana
authors.initials: S
authors.lastname: Krasnokutsky
authors.forename: Joseph
authors.initials: J
authors.lastname: Leung
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Swearingen
authors.forename: Michael H
authors.initials: MH
authors.lastname: Pillinger
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D006073:Gout / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000453:epidemiology*; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors