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 .
Gout impacts on function and health-related quality of life beyond associated risk factors and medical conditions: results from the KING observational study of the Italian Society for Rheumatology (SIR)
Introduction Gout is the most prevalent arthritis and significantly impacts on function and quality of life . Given that gout associates with disabling comorbid conditions , it is not clear whether such a complex of diseases accounts for the increased disability or if gout may play a role by itself . This study aims to evaluate the specific influence of gout and disease-related features on functional disability and health-related quality of life ( HRQoL ) in patients with gout followed in rheumatology clinics . Methods A r and om sample of patients was drawn from clinical registries of 30 rheumatology clinics across Italy . Sociodemographic , general health and gout-specific variables were collected . Functional disability and HRQoL were assessed by the  health assessment question naire ( HAQ )  and the Physical and Mental Component Summary scores ( PCS and MCS ) of the Short Form-36 ( SF-36 ) . Crude and adjusted ordinal logistic and linear regression models were applied to investigate the specific contribution of different variables on HAQ and SF-36 scores . Results are presented as odds ratio ( OR ) or mean difference ( MD ) and 95 % confidence intervals . Results Out of 446 patients with gout , 90 % were males with a mean age of 63.9 years and median disease duration of 3.8 years ; the majority of patients were overweight or obese , and with several comorbidities ; 21.1 % showed at least moderate disability ; the PCS score was significantly lower than expected age- and gender-matched sample s in the general population , while MCS score was not . After adjusting for potential sociodemographic and general-health confounders , gout-specific variables significantly impacted on HAQ , including polyarticular involvement OR 3.82 ( 1.63 , 8.95 ) , presence of tophi OR 1.92 ( 1.07 , 3.43 ) and recent attacks OR 2.20 ( 1.27 , 3.81 ) . Consistent results were found for PCS . The impairment of PCS compared to the general population was limited to patients with features of chronic gout . MCS was only affected by recent attacks ( MD -2.72 [ -4.58 , -0.86 ] ) and  corticosteroid  treatment ( -3.39 [ -5.30,-1.48 ] ) . Conclusions The data from the KING study confirm that gout impacts on disability and provide evidence for an independent association of gout and gout-related features with functional outcome and HRQoL. This result supports the need to improve specific treatment in gout
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 .