Hand function in gout: a comparative study with rheumatoid arthritis and healthy

Mete, Oguzhan; Apaydin, Hakan; Varol, Fatmagül; Gülöksüz, Emine Gözde Aydemir; Pamukcu, Melih

doi:10.1590/1806-9282.20250054

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Original Article • Rev. Assoc. Med. Bras. 71 (6) • 2025 • https://doi.org/10.1590/1806-9282.20250054 linkcopy

Hand function in gout: a comparative study with rheumatoid arthritis and healthy

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OBJECTIVE: The aim of the study was to compare the hand function (grip strength and grip endurance, manual dexterity, and perceived hand functional disability) of participants with gout, rheumatoid arthritis, and healthy control.

METHODS: Grip strength and grip endurance were assessed using a hand dynamometer, while manual dexterity was evaluated through the Nine-Hole Peg Test. Perceived hand functional disability was measured using the Duruöz Hand Index.

RESULTS: The grip strength was similar between gout and healthy control (p>0.05). Dominant and non-dominant grip endurance in gout were lower than healthy control (p=0.008, p=0.001). The dominant placing, removing, and total Nine-Hole Peg Test time of gout compared to healthy control were higher (p=0.001, p<0.001, and p<0.001). The non-dominant placing, removing, and total Nine-Hole Peg Test time of gout were higher than healthy control (p=0.002, p=0.004, and p=0.002). The Duruöz Hand Index in gout was higher than healthy control (p=0.002), but lower than rheumatoid arthritis (p=0.008).

CONCLUSION: Our findings indicate that individuals with gout experience impairments in grip strength, manual dexterity, and perceived hand function. Assessing hand function during clinical examinations of patients with gout should be considered.

KEYWORDS:
Gout; Arthritis; Hand; Grip; Functional status

		Gout group (n: 26)
Duration of diagnosis [months, median (IQR)]		70.0 (96.0)
Medication [n/26 (%)]
	None	1 (3.8)
	Allopurinol	18 (69.2)
	Colchicine	21 (80.8)
Urate lowering treatment [n (%)]
	Yes	18.0 (69.2)
	No	8.0 (69.2)
Presence of hand tophi [n (%)]
	Yes	0.0 (0.0)
	No	26.0 (100.0)
Serum uric acid (mg/dL, X±SD)		7.09±1.59
Serum creatinine [mg/dL, median (IQR)]		1.03 (0.30)
CRP [mg/L, median (IQR)]		5.0 (11.0)
ESR [mm/h, median (IQR)]		12.0 (20.0)
		Rheumatoid arthritis group (n: 25)
Duration of diagnosis [months, median (IQR)]		66.0 (112.50)
Medication [n (%)]
	sDMARDs	22.0 (88.0)
	bDMARDs	1.0 (4.0)
	sDMARDs+bDMARDs	2.0 (8.0)
Swollen joint count [median (IQR)]		0.0 (2.0)
Tender joint count [median (IQR)]		0.0 (2.0)
CRP [mg/L, median (IQR)]		4.50 (7.25)
ESR [mm/h, median (IQR)]		12.50 (18.50)
DAS-28 CRP [median (IQR)]		2.05 (1.30)
DAS-28 ESR [median (IQR)]		2.42 (1.55)

Assessment parameters X±SD, median (IQR)		G1	G2	G3	P0	P1	P2	P3
Grip strength (kg-F)
	DM	33.34±12.43	27.28±11.58	42.32±10.86	<0.001 a *	0.202	0.023	<0.001 **
	NDM	31.30±12.90	26.60±13.19	39.68±10.68	0.001 a *	0.530	0.053	0.001 **
Grip endurance (s)
	DM	4.70 (5.92)	4.46 (4.97)	10.22 (4.65)	<0.001 b *	0.277	0.008 **	<0.001 **
	NDM	5.44 (2.70)	4.48 (3.71)	8.92 (3.45)	<0.001 b *	0.162	0.001 **	<0.001 **
Nine-Hole Peg Test (s)
	DM placing time	18.75 (8.57)	17.94 (6.45)	15.09 (2.32)	<0.001 b *	0.999	0.001 **	<0.001 **
	DM removing time	6.09 (1.52)	7.18 (3.57)	4.81 (2.01)	<0.001 b *	0.051	<0.001 **	<0.001 **
	DM total time	24.86 (8.75)	25.30 (9.06)	19.44 (3.62)	<0.001 b *	0.517	<0.001 **	<0.001 **
	NDM placing time	18.46 (5.49)	19.28 (2.78)	15.45 (3.10)	<0.001 b *	0.311	0.002 **	<0.001 **
	NDM removing time	6.09 (1.74)	7.41 (1.81)	4.89 (1.65)	<0.001 b *	0.009 **	0.004 **	<0.001 **
	NDM total time	25.01 (7.25)	27.15 (3.71)	20.58 (4.14)	<0.001 b *	0.058	0.002 **	<0.001 **
	DHI score	2.00 (6.00)	10.00 (15.00)	0 (0)	<0.001 b *	0.002 **	0.008 **	<0.001 **

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[TFN1] n: number; kg/m²: kilogram/meter square; IQR: interquartile range; X: mean; SD: standard deviation; sDMARDs: synthetic disease-modifying anti-rheumatic drugs; bDMARDs: biologic disease-modifying anti-rheumatic drugs; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; mg/dL: milligram/deciliter; mg/L: milligram/liter; mm/h: millimeter/hour; DAS-28: disease activity score.