Rheumatologic View of the Rheumatoid Foot

Smyth, Charley J.; Janson, Robert W

doi:10.1097/00003086-199707000-00003

Cited by 35 publications

(19 citation statements)

References 30 publications

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“…The implications may be even more severe for patients suffering from rheumatoid arthritis (RA), which is one of the most frequent reasons of limited functional capacity [2] and affects about 0.3-1.5% of the population world wide [3]. Rheumatoid feet are often affected by pain and multiple deformities and may therefore be the primary cause for limitations in function and quality of life [4].…”

Section: Introductionmentioning

confidence: 99%

Assessment of foot impairment in rheumatoid arthritis patients by dynamic pedobarography

et al. 2008

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Section: Introductionmentioning

confidence: 99%

Assessment of foot impairment in rheumatoid arthritis patients by dynamic pedobarography

et al. 2008

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“…Also, the use of imaging techniques helps the physicians to evaluate the progression of disease and to determine the best methods of management (3-5,9 -15). In clinical practice, the detection of involved structures is usually made by the clinical examination associated with radiographic evaluation (4,10,16,17).…”

Section: Introductionmentioning

confidence: 99%

“…There is accumulating evidence that the detection of involved sites, i.e., joint or tendon, and their degree of inflammation is underestimated by clinical and radiographic evaluation (1,17). Therefore the response to CS injections may vary considerably among patients because the physician can perform the injection in an unaffected site or can fail to inject all affected sites (18 -21).…”

Section: Introductionmentioning

confidence: 99%

Impact of ultrasound imaging on local corticosteroid injections of symptomatic ankle, hind‐, and mid‐foot in chronic inflammatory diseases

D'Agostino¹,

Ayral²,

Baron³

et al. 2005

Arthritis & Rheumatism

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Objective. To assess the impact of ultrasonography (US) on local corticosteroid (CS) injections of painful ankle, hindfoot, and midfoot in chronic inflammatory diseases.Methods. Consecutive patients with chronic rheumatic diseases admitted to the hospital for local CS injections of painful ankle, hindfoot, or midfoot were enrolled in this study. Clinical and radiographic evaluation was performed by the physician in charge of CS injections, and US examination was performed by an independent examiner blinded to the clinical and radiologic findings. According to a randomized weekly-periods design, the physician planned CS injections either aware (G1 group) or unaware (G2 group) of US results. In the latter case, he was nonetheless informed of US results after he had performed the injections. Impact of this information on the treatment planning was assessed in all cases. Prognostic impact of US was also evaluated by comparing the change in global assessment of efficacy of CS injections, in activity of the disease, and in the Western Ontario and McMaster Universities (WOMAC) subscales after 1 and 3 months, between G1 and G2 groups. Results. The knowledge of US findings led the physician to change his decision of local CS injections in 56 (82%) of 68 patients studied. Among 1,131 assessed sites, by clinical, radiographic, and US evaluation, injection was cancelled in 37 (15%) of 242 proposed sites, whereas it was decided in 74 (8%) additional sites. After 1 month, there was an improvement in G1 as compared with G2 groups. The mean ؎ SD change in WOMAC physical function subscale was 15.6 ؎ 17.5 in G1 versus 8 ؎ 13 in G2 (P ‫؍‬ 0.0305). After 3 months, only the global assessment of efficacy of CS injections was statistically greater in G1 than in G2 group (P ‫؍‬ 0.0170). Conclusion. US frequently led the physician to change his diagnosis of inflammatory lesions in painful foot, and consequently his planning of CS injections. Moreover, US could improve the response to local treatment.

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“…RA has been strongly associated with the class II major histocompatibility complex, specificity human lymphocyte antigen DR4, and it has been hypothesized that a viral infection, either directly or indirectly, may trigger the inflammatory reaction. 42,74 Regardless of the etiology, the final common pathway of joint destruction results from T-cells (and B-cells) inciting up-regulation of endothelial adhesion molecules, and leukocyte migration into proliferative synovial tissue, and stimulating chondrocytes and synovial fibroblasts to release degradative enzymes (e.g. proteases).…”

Section: Introductionmentioning

confidence: 99%

A Review of Rheumatoid Arthritis Affecting the Foot and Ankle

Jaakkola

Mann²

2004

Foot Ankle Int.

106

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Rheumatoid arthritis is a systemic disease that often affects the foot and ankle. Approximately 20% of patients with rheumatoid arthritis present initially with foot and ankle symptoms, and most patients will eventually develop foot and ankle symptoms. Although early intervention includes conservative measures, operative treatment often is needed to adequately treat rheumatoid patients. Treatment of foot and ankle problems in patients with rheumatoid arthritis is directed to maintaining ambulatory capacity. This article reviews the clinical presentation, evaluation, and treatment of rheumatoid arthritis affecting the foot and ankle.

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Rheumatologic View of the Rheumatoid Foot

Cited by 35 publications

References 30 publications

Assessment of foot impairment in rheumatoid arthritis patients by dynamic pedobarography

Assessment of foot impairment in rheumatoid arthritis patients by dynamic pedobarography

Impact of ultrasound imaging on local corticosteroid injections of symptomatic ankle, hind‐, and mid‐foot in chronic inflammatory diseases

A Review of Rheumatoid Arthritis Affecting the Foot and Ankle

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