Frequency of Achilles and plantar calcaneal spurs in patients with gout

Gout is a prevalent chronic inflammatory arthropathy characterized by the deposition of monosodium urate crystals, primarily affecting joints and surrounding soft tissues. Commonly impacted areas include the first metatarsophalangeal joint, midfoot, and knee, with significant involvement of tendons, especially the Achilles and peroneal tendons. If untreated, gout can lead to severe radiographic changes such as cartilage loss and spur formation, particularly calcaneal spurs at the Achilles tendon and plantar aponeurosis attachments. However, the frequency of these spurs in gout patients and their influencing factors remains unclear. This study aims to investigate the prevalence of Achilles and plantar spurs among gout patients. A single-centre retrospective study was conducted involving patients aged 18-75 diagnosed with gout, identified through hospital records using ICD codes. Data on demographics, clinical features, comorbidities, and radiographic findings were collected. Lateral foot radiographs were evaluated for the presence and grading of Achilles and plantar spurs. Among 376 screened patients, 61 were diagnosed with gout, and 30 had lateral foot radiographs. The mean uric acid level was 8.5±1.8 mg/dL. Metabolic comorbidities were present in 60% of gout patients, with hypertension as the most common (50%). Notably, 43.3% of patients exhibited at least a score-2 spur for both Achilles and plantar regions. Higher age, longer disease duration, and increased metabolic comorbidities correlated with spur presence. Calcaneal spurs are highly prevalent in gout patients, with significant associations to metabolic comorbidities, particularly hypertension. Patients with spurs exhibited higher age, longer disease duration, and greater metabolic issues compared to those without, indicating the need for further investigation into the pathophysiological mechanisms underlying spur development in gout.