期刊連結：http://www.gouthyperuricemia.com

Purpose: The foot is the most commonly involved site in people with gout. This review summarises the pattern of foot involvement in gout, the impact of gout in the foot with regard to patient-reported and clinician-assessed outcomes and reviews current data addressing non-pharmacological management of the foot in people with gout.
Findings: The first metatarsophalangeal joint and Achilles tendon are frequently affected by gout. Many factors have been proposed to explain the predilection for gout to affect the foot including reduced temperature, susceptibility to physical trauma, biomechanical loading during gait and concomitant osteoarthritis. People with gout report persistent foot-related pain and disability which is reflected in clinician-observed gait impairments, reduced foot and ankle joint function and lower limb and foot muscle weakness. Good footwear and podiatric palliative care may play an important role as part of the multidisciplinary management of gout in combination with urate lowering therapy.
Conclusion: The exact mechanism responsible for the high frequency of gout in the foot remains unclear. However, people with gout present with chronic pain, and structural and functional impairments related to the foot which greatly affects their ability to participate in everyday activities. Health care professionals may consider local ice therapy, footwear advice and podiatric referrals as part of the management plan aimed at improving foot-related pain and gait disability in people with gout.