Identifying tophaceous gout in foot ulcers using ulcer debris microscopy in Type 2 diabetes.

Gout is frequently underdiagnosed in patients with diabetes. As a chronic disease characterised by urate deposition, gout can lead to the formation of tophi in the feet, which may ulcerate. However, the prevalence of tophaceous gout in patients with diabetes and foot ulcers has not been previously s...

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Publicado en:Journal of Wound Management Vol. 26; no. 3; pp. 175 - 182
Autores principales: </strong>, <strong>Author(s), Rasmussen, Claus, Larsen, Jesper Walther, Holm, Peter CW, Bisgaard, Trine Stenbak, Søbye, Marie-Louise Lund, Jepsen, Søren Terpager, Nielsen, Gunnar L, Jurik, Anne Grethe
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Cambridge Publishing Nov2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2025
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      pub: Cambridge Publishing
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        10.35279/jowm2025.26.03.08
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        atl: Identifying tophaceous gout in foot ulcers using ulcer debris microscopy in Type 2 diabetes.
      aug:
        au:
          </strong>, <strong>Author(s)
          Rasmussen, Claus
          Larsen, Jesper Walther
          Holm, Peter CW
          Bisgaard, Trine Stenbak
          Søbye, Marie-Louise Lund
          Jepsen, Søren Terpager
          Nielsen, Gunnar L
          Jurik, Anne Grethe
        affil: Søren Terpager Jepsen 6, Gunnar L Nielsen 5,7, Anne Grethe Jurik 4, 1 Department of Rheumatology, North Denmark Regional Hospital, Hjørring, Denmark
      sug:
        subj:
          Gout Diagnosis
          Foot Ulcer
          Microscopy
          Diabetes Mellitus, Type 2
          Denmark
          Human
          Male
          Female
          Middle Age
          Aged
          Diabetic Patients
          Pilot Studies
          Prospective Studies
          Quality Improvement
          Chi Square Test
          Fisher's Exact Test
          Mann-Whitney U Test
          Descriptive Statistics
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Gout is frequently underdiagnosed in patients with diabetes. As a chronic disease characterised by urate deposition, gout can lead to the formation of tophi in the feet, which may ulcerate. However, the prevalence of tophaceous gout in patients with diabetes and foot ulcers has not been previously studied. This study explored the feasibility of sampling foot ulcer debris for polarised light microscopy to detect birefringent urate crystals and identify cases of gout in patients with diabetes. Among 36 ulcer debris samples examined, urate crystals were identified in five cases (14%) strongly suggesting previously unrecognised gout. Radiographic findings further supported tophaceous gout as the primary cause of these foot ulcers. These findings indicate that unrecognised tophaceous gout may be relatively common among patients with Type 2 diabetes and foot ulcers. However, selection bias may have led to an overestimation of prevalence, while insufficient or contaminated samples may have resulted in an underestimation. Further refinement of sampling and examination techniques--ideally supplemented by imaging prior to ulcer treatment --is needed to improve the detection of all cases with urate crystals and to ensure that negative findings truly reflect the absence of gout rather than technical limitations.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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