Comparative Distribution of Ultrasound‐Detectable Forefoot Bursae in Patients With Osteoarthritis and Rheumatoid Arthritis

Abstract

Objective. To investigate the prevalence and distribution of forefoot bursae (FFB) in individuals with osteoarthritis (OA), individuals with rheumatoid arthritis (RA), and healthy controls (HCs), and to identify mechanical or inflammatory factors predicting FFB count. Methods. A cross-sectional observational study was completed in 3 cohorts: OA (n ‫؍‬ 50), RA (n ‫؍‬ 56), and HC (n ‫؍‬ 50). FFB were recorded as present if detectable in 2 ultrasound (US) scanning planes. The comparative probabilities of FFB presence between groups were expressed as odds ratios. Mechanical factors, including joint deformity, range of motion, and foot posture, were determined for both patient groups. Inflammatory factors, including serology, Disease Activity Score in 28 joints, and US-detected metatarsophalangeal joint hypertrophy and metatarsal head erosion, were determined for RA patients. Multiple linear regression analyses were used to determine factors related to FFB count in the patient groups. Results. FFB were highly prevalent in both the OA and RA groups (94 per 100 patients and 88 per 100 patients, respectively) compared with the HC group (56 per 100 participants). FFB distribution significantly differed between the patient groups (RA-OA: 2 ‫؍‬ 15.64, P < 0.001). In OA patients, FFB were commonly located in the medial/lateral forefoot region, but were located across all regions for RA patients. In OA patients, reduced ankle joint range of motion predicted FFB count (R 2 ‫؍‬ 0.09, P ‫؍‬ 0.037). In RA patients, erosion presence was related to FFB count (R 2 ‫؍‬ 0.18, P < 0.001). Conclusion. FFB were highly prevalent in patients with OA and RA. FFB distribution significantly differed between the patient groups. FFB in patients with OA may be related to mechanical factors.

Increased frequency of intermetatarsal and submetatarsal bursitis in early rheumatoid arthritis: a large case-controlled MRI study

“…It is difficult to compare our findings to previous studies in RA, as they utilized ultrasound and included patients with established RA receiving treatment rather than early disease [ 8 , 33 ].…”

Avaliação Da Amplitude De Movimento Na Artrite Reumatóide: Uma Revisão De Literatura

“…Nesta revisão bibliográfica, as formas de avaliação da ADM que mais predominaram foram a Goniometria (12 artigos), Escala da Escola Paulista de Medicina -Joint of Motion (EPM-ROM) (12 artigos) e Análise Cinemática (7 artigos), sendo que os demais artigos apresentavam protocolos de medida articular não comuns na prática clínica, como classificação por escores (HOOPER et al, 2014), teste funcional Keitel (POOLE et al, 2013), teste de mobilidade da mão (POOLE et al, 2013), "Working space of the hand" (DIAS et al, 2009), análise radiográfica (TÄGIL et al, 2009), teste do pêndulo (VALLE et al, 2006), índice de lesão articular (JOHNSON et al, 2002), estimativa visual (ORCES et al, 2002) e escala de movimento e alinhamento articular (CRANNEY et al, 1999).…”

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

“…A positive likelihood ratio of 4.6 % was found when a cut-off of ˃2 mm for retrocalcaneal bursa thickness was used. Of note, the retrocalcaneal bursa could be seen by US in 27.6 % of healthy people 191 and in nearly 50 % of military recruits 156 . In addition, retrocalcaneal bursitis was frequently observed in RA (in 24 % of established and 38 % of early RA patients) 165 .…”

“…In the foot, US was able to identify forefoot bursae distention (intermetatarsal and plantar) with a high prevalence in both OA (94 %) and RA (88 %) compared to healthy subjects (56 %) [191]. These bursae are often missed by clinical examination (US vs. clinical examination: 92.6 % vs. 23.5 % in RA) and their presence is associated with self-reported activity restrictions and foot impairment [192].…”