Clinical Report: Is Gout Linked to Achilles Tendon Rupture?

Background

Gout is a prevalent form of arthritis that primarily affects joints but can also impact tendons and ligaments. Tendon involvement, particularly in chronic cases, can lead to significant functional impairment.

Data Highlights

The patient had a serum urate concentration of 9.6 mg/dL and MRI-confirmed bilateral Achilles tendon rupture with gap formation measuring approximately 4.5 cm on the left and 2 cm on the right.

Key Findings

• A 68-year-old male with poorly controlled tophaceous gout developed bilateral Achilles tendon rupture.
• Chronic intratendinous monosodium urate crystal deposition may weaken tendon structure.
• Recent fluoroquinolone exposure was noted as a potential contributing factor to the tendon rupture.
• Extensive tophaceous deposition was observed in multiple tendons, including the Achilles tendon.
• The proposed “two-hit” model suggests both chronic gout and recent antibiotic exposure contributed to the rupture.

Clinical Implications

Clinicians should maintain a high index of suspicion for tendon complications in patients with chronic gout, particularly when prescribing fluoroquinolones.

Conclusion

Further research is warranted to establish causal relationships and improve patient management.

Related Resources & Content

1. Sathapanasiri T, et al., ACR Open Rheumatology, 2023 -- Is Gout Linked to Achilles Tendon Rupture?
2. ACR Open Rheumatology, 2023 -- Clinical Images: Achilles tendon rupture in rheumatoid arthritis
3. Frontiers in Medicine, 2026 -- Correlation analysis of metabolic parameters influencing postoperative tendon healing after Achilles tendon rupture repair
4. Clinical Rheumatology, 2026 -- Gout and allopurinol adherence in newly diagnosed patients and the risk of fractures: a nationwide cohort study
5. 2020 American College of Rheumatology Guideline for the Management of Gout - PMC
6. Tendon involvement in the feet of patients with gout: a dual-energy CT study - PubMed
7. Hyperuricemia as an independent risk factor for achilles tendon rupture in male: a case–control study - PMC
8. 2020 American College of Rheumatology Guideline for the Management of Gout - PMC
9. Tendon involvement in the feet of patients with gout: a dual-energy CT study - PubMed
10. Hyperuricemia as an independent risk factor for achilles tendon rupture in male: a case–control study - PMC