Bálint Géza P, Korda Judit, Hangody László, Bálint Péter V
4th Department of Rheumatic Diseases, National Institute of Rheumatology and Physiotherapy, 38-40 Frankel L. Street, Budapest 1023, Hungary.
Best Pract Res Clin Rheumatol. 2003 Feb;17(1):87-111. doi: 10.1016/s1521-6942(02)00103-1.
Foot pain is very common, especially in women, owing to inappropriate footwear. Overuse, repetitive strain and minor, easily forgettable injuries may result in chronic foot and ankle pain. Rheumatoid arthritis, spondyloarthropathies and gout frequently affect the foot, often as a first presentation. Charcot's joints and foot infections are not rare in diabetes. The rheumatologist should be familiar with foot disorders, either localized or as manifestations of generalized disease. History taking, physical examination, identification of the source of pain by intra-articularly given local anaesthetics and imaging methods should be used to reveal the underlying disorder. Correct diagnosis and efficient therapy-including local steroid injections, physiotherapy, orthoses, surgery-are necessary not only for treatment but also for preventing biomechanical chain reactions. This chapter gives an overview of the epidemiology, diagnosis and treatment of foot pain and foot disorders caused by both local and generalized diseases.
足部疼痛非常常见,尤其是在女性中,这是由于鞋类不合适所致。过度使用、重复性劳损以及轻微且易被忽视的损伤都可能导致慢性足踝疼痛。类风湿关节炎、脊柱关节病和痛风经常累及足部,且常常是首发表现。夏科关节病和足部感染在糖尿病患者中并不罕见。风湿病学家应熟悉足部疾病,无论是局限性的还是作为全身性疾病的表现。应通过病史采集、体格检查、关节内注射局部麻醉剂来确定疼痛来源以及采用影像学方法来揭示潜在疾病。正确的诊断和有效的治疗——包括局部类固醇注射、物理治疗、矫形器、手术——不仅对于治疗是必要的,而且对于预防生物力学连锁反应也是必要的。本章概述了由局部和全身性疾病引起的足部疼痛及足部疾病的流行病学、诊断和治疗。