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 .
Epidemiology of gout and hyperuricemia. A long-term population study.
T HE characteristics of a disease as it appears in the general population are likely to be quite different from its characteristics in a hospital population , since only patients who are severely afflicted or in whom complications have developed are likely to be found in the hospital population . Analysis of a hospital population , therefore , will give an exaggerated idea of the usual severity of the disease and of the frequency with which complications occur . A similar bias may be introduced when patients coming to the hospital with other complaints are used as controls , and an even greater bias introduced when autopsy series are used . This paper presents some observations of a forward-going study of an adult population sample in respect to the characteristics of hyperuricemia and gouty arthritis . The characteristics investigated include ( 1 ) the prevalence of hyperuricemia and its relationship to age ; ( 2 ) the prevalence of secondary hyperuricemia ; ( 3 ) the prevalence of gouty arthritis ; ( 4 ) the incidence of gouty arthritis and its relationship to age ; ( 5 ) the relationship of gouty arthritis to hyperuricemia and the risk of developing gouty arthritis for each uric acid level ; ( 6 ) the clinical features of gouty arthritis in this population ; and ( 7 ) the prevalence of complications related to gouty arthritis and to hyperuricemia . In the Town of Framingham , Massachusetts , a population was selected by r and om sampling for the studp of coronaryartery disease and hJ , pertension . This population has been described in detail elsewhere [ /--31 . A total of 5,127 subjects ( 2,283 men and 2,844 women ) , age thirtythrough fifty-nine , free of evidence of coronary heart disease on initial examination , were included in the sample ( hereinafter referred to as the population ) . The mean age on admission was forty-four . Biennial examination included history , physical examination , electrocardiogram , roentgenograms and various laboratory tests . The results of these examinations , transcripts of admission to the community hospital , and information obtained from physicians and hospitals outside the community formed the record of each subject . At the time of this report the population had been examined an average of seven times for a follow-up period of twelve years . A few subjects have died , moved away or have missed one or two examinations for various reasons . Some have had eight examinations . The current health status of approxiluately 95 per cent of the original 5,127 subjects is known and only 0.7 per cent are considered lost to follow-up [ J ]
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 .