The rheumatoid forefoot

Abstract

Rheumatoid arthritis (RA) manifests itself in a variety of ways, with its effect being seen in around 90 % of sufferers' feet. The foot has been found to be the most common reason for incapacity in patients with RA, with the forefoot the most common area. The foot is second, behind only the hand, as the most common place for manifestation of RA. Pain in the foot is commonly the most debilitating condition, which causes the patient to seek specialist help. As well as pain, foot deformities such as hallux valgus and claw toes are common complaints. These symptoms often arise as a result of continued walking on an unstable foot, leading to painful callosities and dislocation of the metatarsophalangeal joints. Other conditions, such as pannus formation and Morton's neuroma, can be related to RA. This review sets out what we believe to be a successful approach to the rheumatoid forefoot, which aims at the relief of pain and the preservation of ambulation. Key to a successful outcome is appropriate medical control with a multidisciplinary approach that enables close liaison between orthopaedic surgeons, orthotists, and rheumatologists. Combined clinics provide this multidisciplinary care. Those treating RA need to be aware of the high incidence of foot involvement and how early intervention may benefit the patient. The aim of this article is to present current evidence to enable people to develop a treatment algorithm for this condition.

Quality of life impact related to foot health in a sample of sea workers

“…However, based on the results of the few studies carried out on this matter [16,17], the impact of the quality of life related to foot health is not as obvious as it appears to be, whereas the results of the present study confirm that people who work at sea present lower scores on the dimensions related to foot pain, foot function, general foot health and social function, than people who work on the ground with normalised reference values. Taking into account these results, it seems necessary to point out the importance of the care and control of the foot in what regards medical and podiatric care in order to prevent the appearance of illnesses and deformities of the foot, this being a key aspect that would allow to improve sea workers' health, quality of life and autonomy.…”

Impact on quality of life related to foot health in a sample of menopausal women: a case–control observational study

“…Foot problems have been recognized as a public health threat as stated by Nisar and colleagues, who analyzed a sample of 3062 participants with menopause, reporting 861 individuals (28.1%) with muscle and joint pain, which appears to be associated with age, education and menopausal status 4 . In addition, other studies have indicated less satisfaction with the quality of life related to health 19-21 . However, based on the results of the few studies reporting on this subject 22,23 , the impact of the quality of life related to foot health is not as obvious as it appears to be. The results of the present study confirm that menopausal women present with lower scores on the quality-of-life dimensions related to foot health compared to non-menopausal women with normalized reference values.…”

Rheumatoid Arthritis: A Brief Overview of the Treatment

“…Joint fusion can be done to stabilize joints that are not easily replaceable such as the ankle, wrist, thumb, and cervical spine. A procedure for soft-tissue release can be done to correct severe contractures around joints causing decreased range of motion; this is an older procedure that is not commonly utilized [45]. Small-joint implant arthroplasty can be done to reduce pain and improve hand function, most commonly in the metacarpophalangeal joints.…”