Frequency of erosive arthritis and associated factors in gout patients: a single-center radiological study

BACKGORUND: There are limited data on radiographic frequency of erosive artrhritis (EA) in gout patients. AIM: To describe the frequency, and associated factors of EA in gout patients. MATERIALS-METHODS: Adult patients diagnosed with gout according to the 2015 ACR/EULAR Classification Criteria were enrolled from a single tertiary rheumatology center. Medical records were reviewed retrospectively. Anteroposterior foot radiographs were independently evaluated by two rheumatologists. Erosive arthritis was defined as the presence of a cortical break with sclerotic margins and an overhanging edge appearance in at least one metatarsophalangeal joint. RESULTS: A total of 210 patients were included in study, with a mean age of 57.8 years, and 88.1% were male. Median disease duration was five years. The freqeuncy of tophus was 10.5% (n = 22), and 20% of patients (n = 42) had EA. In EA-positive group, alcohol consumption (p = 0.022), disease duration (p < 0.001), upper extremity joint arthritis (p < 0.001), knee arthritis (p = 0.005), serum urate level (p = 0.029), and the presence of tophus (p < 0.001) were significantly higher. In multivariable regression analysis, disease duration (p < 0.001; OR = .903, 95% CI: .859-.949), alcohol consumption (p < 0.001; OR = 46.361, 95% CI: 10.955-196.204), and the presence of tophus (p = 0.041; OR = 2.693, 95% CI: 1.043-6.953) were identified as potential independent predictive factors of EA. CONCLUSION: Our finding of an association between alcohol consumption and EA is particularly striking. Prospective studies using sensitive imaging modalities are needed to further elucidate this relationship.