1st MTP pain was a prominent feature in people with gout .
Imaging features were common at the 1st MTP including the double contour sign , tophi and erosions .
Conclusions 1st MTP acute arthritis is highly prevalent in people with gout and has a substantial impact on patient-reported pain and disability .
Gout affects the structure and function of the 1st MTP .
Microscopic and imaging studies have demonstrated crystal deposition and joint damage at the 1st MTP in people with gout
Background The aim of this review was to qualitatively synthesis e studies that have investigated characteristics of the  first metatarsophalangeal joint ( 1st MTP )  in gout and to undertake a meta- analysis to estimate the average prevalence of acute 1st MTP arthritis across studies in people with gout .
Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout?
Objective The primary objective of this prospect i ve case-control study was to assess the diagnostic value of several intra-articular and periarticular ultrasound (US)-detected abnormalities in the upper and lower limbs in gout . The secondary objective was to test the concurrent validity of US abnormalities using as gold st and ard the microscopic demonstration of monosodium urate ( MSU ) crystals . Methods Ninety-one men with gout and 42 age-matched controls were prospect ively recruited . All patients with gout and controls underwent US assessment of several US abnormalities in 26 joints , six bursae , eight tendons , 20 tendon compartments , four ligaments , and 18 articular cartilages by experts in US blinded to the patients ’ group . Patients with gout and controls with US abnormalities were asked to undergo US-guided aspiration for microscopic identification of MSU crystals . Interobserver and intraobserver reliability of the US assessment was evaluated in a web-based exercise . Results The assessment of one joint ( ie , radiocarpal joint ) for hyperechoic aggregates ( HAGs ) , two tendons ( ie , patellar tendon and triceps tendon ) for HAGs and three articular cartilages ( ie , first metatarsal , talar and second metacarpal/femoral ) for double contour sign showed the best balance between sensitivity and specificity ( 84.6 % and 83.3 % , respectively ) . Intraobserver reliability was good ( mean κ 0.75 ) and interobserver reliability was moderate ( κ 0.52 ) . The aspirated material from HAGs was positive for MSU crystals in 77.6 % of patients with gout and negative in all controls . Conclusions Our results suggest that US bilateral assessment of one joint , three articular cartilages and two tendons may be valid for diagnosing gout with acceptable sensitivity and specificity
1st MTP pain was a prominent feature in people with gout .
Imaging features were common at the 1st MTP including the double contour sign , tophi and erosions .
Conclusions 1st MTP acute arthritis is highly prevalent in people with gout and has a substantial impact on patient-reported pain and disability .
Gout affects the structure and function of the 1st MTP .
Microscopic and imaging studies have demonstrated crystal deposition and joint damage at the 1st MTP in people with gout
Background The aim of this review was to qualitatively synthesis e studies that have investigated characteristics of the  first metatarsophalangeal joint ( 1st MTP )  in gout and to undertake a meta- analysis to estimate the average prevalence of acute 1st MTP arthritis across studies in people with gout .