Which joints are most commonly involved in gout?
The joints of the lower limbs are typically involved most often, although gout has been reported to involve almost any joint. Termed podagra, the first metatarsophalangeal is involved in >50% of initial flares and over time is affected in the vast majority of patients. Other commonly involved sites include joints of the mid- and hind-foot, knees, wrists, fingers, and elbows. Flares involving axial sites (spine or sacroiliac joint) are rare. Gout and tophi have a predilection for cooler, acral sites where the solubility of MSU crystals (as well as circulation) may be diminished as a result of the cooler temperatures. In addition, joints that have undergone degenerative changes appear to provide a nidus that facilitates crystal formation.
