Does Bone Necrosis Affect Height Development in Gout Patients?

Does bone necrosis affect height development?

Earlier this year, I experienced sudden pain and swelling in my arches and the tops of my feet.
When there is no pain, there is slight swelling and discomfort in the posterior part of the arch, especially after standing for long periods.
This has occurred about 2-3 times a year and has troubled me for over ten years, starting around the age of 14.
During this time, I have consulted multiple doctors, but most treatments involved medication and injections.
At 19, I underwent examinations at a hospital and discovered avascular necrosis of the navicular bones in both feet.
I received treatment for my right foot, and while there was no swelling in my left foot when asymptomatic, the underlying issue remained unresolved.
Earlier this year, I experienced pain and swelling again, and after undergoing a uric acid test, I was diagnosed with gout.
Since controlling it, I have not had an episode for six months.

I would like to ask if gout can cause bone necrosis, and whether bone necrosis can affect height development?

Mk, 20~29 year old female. Ask Date: 2023/10/15

Dr. Shi Guozheng reply Orthopedics

1.
Gout does not cause bone necrosis.
2.
It does not affect height in the ankle region; however, it can impact height if it occurs in the hip or knee joints.

Reply Date: 2023/10/15

More Info

Gout is a type of inflammatory arthritis characterized by the accumulation of uric acid crystals in the joints, leading to episodes of severe pain, swelling, and redness. While gout itself does not directly cause bone necrosis, the complications associated with chronic gout can lead to conditions that may affect bone health. In your case, the diagnosis of avascular necrosis (bone necrosis) in the navicular bones of your feet is a significant concern. Avascular necrosis occurs when blood supply to a bone is disrupted, leading to bone death and potential structural collapse.

To address your question directly: bone necrosis, particularly in the feet, does not typically affect height development. Height is primarily determined by the growth plates located in the long bones of the legs and the spine. These growth plates remain open during childhood and adolescence, allowing for bone elongation. Once these growth plates close, which usually occurs after puberty, height is no longer affected by conditions in other areas of the body, including the feet.

However, if the necrosis were to occur in the hip or knee joints, where significant weight-bearing and growth plate activity occurs, it could potentially impact overall mobility and function, which might indirectly affect physical activity levels and posture. This could lead to compensatory changes in gait or posture that might influence perceived height, but not actual height.

In your case, the history of recurrent foot pain and swelling, along with the diagnosis of gout, suggests that managing uric acid levels is crucial to prevent further joint damage and complications. While gout itself does not lead to bone necrosis, chronic inflammation and joint damage can result from untreated or poorly managed gout, which may contribute to conditions like avascular necrosis.

It's also important to note that the presence of avascular necrosis can lead to chronic pain and functional limitations, which may affect your quality of life and ability to engage in physical activities. This can create a cycle of reduced activity and potential weight gain, which can further complicate joint health.

In summary, while gout and associated bone necrosis can lead to significant pain and functional limitations, they do not directly affect height development. Height is primarily influenced by genetic factors and the health of the growth plates in the long bones. If you have concerns about your bone health or the impact of gout on your overall well-being, it is advisable to consult with a healthcare professional who can provide personalized guidance and treatment options. Regular monitoring and management of uric acid levels, along with appropriate interventions for any bone necrosis, will be essential in maintaining your overall health and mobility.

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