Radiologic Evaluation of the Arthritic Foot

Objective. Foot and ankle deformities greatly affect the quality of life of rheumatoid arthritis (RA) patients. The aim of this study was to elucidate the pattern of destruction of the RA foot and its impact on patients. Methods. We cross-sectionally investigated RA patients (274 patients and 542 feet) using radiographs. The grade of joint destruction was assigned using Larsen's grading system for 12 joints in the foot and ankle. Cluster analysis was performed using the K-means method to classify the pattern of joint destruction. Of the 274 patients evaluated radiographically, 212 were assessed for functional disability using questionnaires. Results. Cluster analysis revealed that 542 feet were divided into 5 clusters, named according to the characteristic distribution of joint destruction: cluster I (normal type), cluster II (forefoot type), cluster III (midfoot type), cluster IV (mid-hindfoot type), and cluster V (combined type). Radiographic measurements revealed the characteristic deformities of each cluster: splay foot for cluster II, flat foot for cluster III, hindfoot malalignment for cluster IV, and mixtures of these characteristics for cluster V. A distribution map of each cluster based on disease duration revealed that cluster III peaked in cases of 5-10-year disease duration and subsequently decreased, followed by a gradual increase of cluster IV and cluster V. Cluster IV and cluster V showed significant changes in functional disability compared to cluster III. Conclusion. This report is the first to reveal the pattern of RA foot deformities and their impact on patients using statistical measures in a large series.

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“…The ankle was the least damaged joint in our study. This preferential joint destruction is consistent with previous reports ().…”

Section: Discussionsupporting

confidence: 94%

Radiologic Patterning of Joint Damage to the Foot in Rheumatoid Arthritis

Matsumoto

Nakamura

Miura

et al. 2014

Arthritis Care & Research

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“…Suitable shoes and plantar orthoses should be prescribed. The latter should be used early, as soon as there is inflammatory involvement of the foot, for effective correction and relief [14,21,28].…”

Section: Indicationsmentioning

confidence: 99%

Chaussage et orthèses plantaires dans la polyarthrite rhumatoïde

Bouysset¹,

Lapeyre²,

Tébib³

et al. 2005

Med Chir Pied

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In rheumatoid arthritis (RA) the aim of footwear prescription and the principal concepts relating to footwear and plantar orthoses are mentioned. The role of plantar orthoses, their materials and composition but also systematic history taking and assessment of the rheumatoid foot, before designing shoes and orthoses, are evoked. The indications of plantar orthoses and footwear are described: in early RA when there is no foot and ankle involvement, when there is metatarsalgia in an inflammatory forefoot without metatarsophalangeal joint erosion on x-ray, when there is metatarso-phalangeal joint erosion. Similarly clinical midhindfoot involvement is considered, when there are subtalar and talo-crural lesions and when the foot deformities are fixed. It is emphasized that the management of the treatment involves a care-team approach.Résumé : Dans la polyarthrite rhumatoïde (PR), la finalité de la prescription d'un chaussage adapté et les grandes notions sur le chaussage et les orthèses plantaires sont exposés. Le rôle des orthèses plantaires, les matériaux qui la composent mais aussi l'interrogatoire et l'examen clinique qui précèdent leur prescription sont évoqués. Les indications des orthèses plantaires et d'un chaussage adapté sont décrites : au stade précoce de la PR, quand il n'y a pas d'atteinte du pied, puis quand il y a une méta-tarsalgie inflammatoire sans érosion métatarsienne radiologique, ensuite en présence d'une érosion métatarsienne. De même quand il y a une atteinte inflammatoire clinique du medio-pied et de l'arrière-pied, quand il y a une atteinte de l'articulation sous-talienne et de la cheville, et quand les déformations sont fixées. Il est souligné que la bonne organisation des soins doit faire intervenir un travail d'équipe.

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The rheumatoid foot. Pathomechanics, clinical and radiological features. Therapeutic conditions

Bouysset

Hugueny

Foot and Ankle in Rheumatoid Arthritis

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Radiologic Evaluation of the Arthritic Foot

Cited by 25 publications

References 15 publications

Radiologic Patterning of Joint Damage to the Foot in Rheumatoid Arthritis

Radiologic Patterning of Joint Damage to the Foot in Rheumatoid Arthritis

Chaussage et orthèses plantaires dans la polyarthrite rhumatoïde

The rheumatoid foot. Pathomechanics, clinical and radiological features. Therapeutic conditions

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