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To what extent is foot pain related to biomechanical changes and ultrasound-detected abnormalities in rheumatoid arthritis?


1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11

 

  1. University Podiatry Clinic, Faculty of E.F. Podiatry Universidad Complutense de Madrid, Spain.
  2. Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. lvalor.hgugm@salud.madrid.org
  3. University Podiatry Clinic, Faculty of E.F. Podiatry Universidad Complutense de Madrid, Spain.
  4. Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  5. Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  6. Department of Preventive Medicine and Public Health, Universidad Complutense de Madrid, Spain.
  7. Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  8. Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  9. Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  10. Department of Social Psychology and Methodology, Universidad Autónoma de Madrid, Spain.
  11. Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

CER8792
2016 Vol.34, N°3
PI 0480, PF 0488
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PMID: 27050868 [PubMed]

Received: 20/07/2015
Accepted : 11/12/2015
In Press: 06/04/2016
Published: 30/05/2016

Abstract

OBJECTIVES:
To investigate the presence of biomechanical abnormalities and ultrasound (US)-detected inflammation and damage in low disease or remission status rheumatoid arthritis (RA) patients with foot complaints.
METHODS:
We recruited 136 subjects with foot complaints. Sixty-two were biologic disease-modifying antirheumatic drug-treated RA patients presenting Disease Activity Score-determined remission or low disease activity while the remaining 74 were gender matched controls without rheumatic or musculoskeletal disorders. Both groups underwent a comprehensive podiatric, biomechanical and B-mode and Doppler US assessment of the feet.
RESULTS:
Most RA patients and controls were female (77.4% and 83.8%, respectively). There was no statistical difference in the proportion of obese subjects in either group (p=0.792). Inappropriate shoes were used by 50.0% of RA patients and 33.8% of controls (p=0.080). Talalgia, particularly heel pain, was more frequent in the control group, with associated talalgia and metatarsalgia being more prevalent in the RA group (p<0.05). The RA patient group was also more likely to present greater foot deformity, more limited joint movement and biomechanical abnormalities than the controls (p<0.05). US inflammatory and structural changes were significantly more frequent in RA patients than in controls (p<0.05). US structural involvement was significantly associated with limited joint mobility and pathologic biomechanical tests only in RA patients (p<0.05).
CONCLUSIONS:
RA foot complaints seemed to be linked to US-detected RA involvement and biomechanical abnormalities. Podiatric and US assessments can be useful to help the clinician to optimise the management of RA patients in remission/low disease activity with foot complaints.

Rheumatology Article