Dietary modification, medication adherence, and follow-up care with a health care providers are opportunities to educate patients with gout, according to a joint clinical consensus statement issued recently by The American College of Foot and Ankle Surgeons ACFAS and the American Association of Nurse Practitioners.

Published in the November/December issues of The Journal of Foot & Ankle Surgery and The Journal for Nurse Practitioners, the statement is intended to serve as a discussion guide for the risk factors, diagnosis, treatment and prevention of the disease.

Among the papers significant agreements are:
  • Nonsteroidal anti-inflammatory drugs should be used as the first line treatment for acute gout.
  • Long-term medications, such as allopurinol, are necessary in the treatment of recurrent gout.
  • Age, diet and alcohol consumption are risk factors for gout.
  • Joint aspiration and microscopy are the gold standards for making the diagnosis of gout.    
  • Multidisciplinary referral provides optimal care in cases of recalcitrant gout.

Gout is a condition that commonly affects the foot and ankle, and practitioners who treat these structures should be aware of the methods used to diagnose and treat this form of arthritis, according to a press release about the statement. 

"In working with an interprofessional team, we have been able to create a thorough consensus statement for the management of patients with gout," co-chair Michael Zychowicz, DNP, ANP, FAAN, FAANP, Professor and Director of the MSN Program & Lead Faculty in Orthopedic NP Specialty at Duke University School of Nursing in Durham, NC explained in the press release. "This document will serve as a valuable clinical guide for the interprofessional management of gout arthritis."


Mirmiran R, Bush T, Cerra MM, et al. Joint Clinical Consensus Statement of the American College of Foot and Ankle Surgeons® and the American Association of Nurse Practitioners®: Etiology, Diagnosis, and Treatment Consensus for Gouty Arthritis of the Foot and Ankle. J Foot Ankle Surg. 2018;57(6):1207–1217.