Sahli Hana, Bachali Asma, Tekaya Raoudha, Mahmoud Ines, Sedki Yassine, Saidane Olfa, Abdelmoula Leila
Department of Rheumatology, Charles Nicolle Hospital, 1006 Tunis, Tunisia; Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia.
Department of Clinical Biology, Mohamed Taher Maamouri Hospital, Nabeul, Tunisia; Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007 Tunis, Tunisia.
Foot Ankle Surg. 2019 Apr;25(2):226-230. doi: 10.1016/j.fas.2017.10.016. Epub 2017 Nov 10.
The purpose of this study was to evaluate the foot involvement in a group of patients with spondyloarthritis in regard to symptoms, type and frequency of deformities, location and radiological changes.
We conducted a cross sectional study including 60 patients with spondyloarthritis over a period of six months. Anamnesis, clinical examination, podoscopic examination, biological tests and X-rays of feet were done for each patient.
Foot involvement was found in 31 patients (52%). It was symptomatic in 35% of cases and inaugural in 42% of cases. The most frequent site was the hindfoot (22 patients/31). Radiological findings were: erosion (17%), reconstruction (33%), erosion and reconstruction (50%). Forefoot involvement was found in 18/31 patients. Forefoot deformities were found in 9 patients. Two patients had sausage toe and feet skin abnormalities were observed in 12 patients. At podoscopic examination, 23 patients had abnormal footprints. Foot involvement was more frequent in peripheral spondyloarthritis (p=0.008). Patients with foot involvement had an advanced age of disease onset (p=0.05), a shorter disease duration (p=0.038) and more comorbidities (p=0.039). Foot involvement was correlated with C Reactive protein (p=0.043).
In our study, foot involvement and foot symptoms were seen frequently in spondyloarthritis and it is associated with late onset of the disease and with higher inflammation in blood tests.
本研究的目的是评估一组脊柱关节炎患者足部受累的症状、畸形类型和频率、部位及放射学改变。
我们进行了一项横断面研究，在六个月的时间里纳入了60例脊柱关节炎患者。对每位患者进行了问诊、临床检查、足部镜检、生物学检测及足部X线检查。
31例患者（52%）存在足部受累。其中35%的病例有症状，42%的病例首发于足部。最常见的部位是后足（22例/31例）。放射学表现为：侵蚀（17%）、重建（33%）、侵蚀并重建（50%）。31例患者中有18例前足受累。9例患者存在前足畸形。2例患者有腊肠趾，12例患者观察到足部皮肤异常。在足部镜检中，23例患者足部印记异常。外周型脊柱关节炎患者足部受累更为常见（p=0.008）。足部受累的患者发病年龄较大（p=0.05），病程较短（p=0.038），合并症更多（p=0.039）。足部受累与C反应蛋白相关（p=0.043）。
在我们的研究中，脊柱关节炎患者中足部受累及足部症状较为常见，且与疾病的晚发及血液检查中较高的炎症反应相关。
