Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan.
Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.
Mod Rheumatol. 2020 Mar;30(2):287-292. doi: 10.1080/14397595.2019.1589921. Epub 2019 Apr 1.
We aimed to investigate the relationship of callosities of the forefoot with foot deformity, the Health Assessment Questionnaire Disability Index (HAQ-DI) and modified total Sharp score (TSS) in patients with rheumatoid arthritis (RA). A total of 202 patients and 404 feet were enrolled. We examined the prevalence of callosities. Clinical data included the HAQ-DI, TSS, hallux valgus angle (HVA), and calcaneal pitch angle (CPA). The analysis of factors associated with callosities of the forefoot was performed by comparing patients with and without callosities of the forefoot. The prevalence of callosities was 31.2% of all patients and 24.0% of all feet. The patients with callosities of the forefoot had significantly higher TSS of the foot. The presence of callosities affected the HAQ-DI walking score. HVA and CPA were identified as being associated with callosities of the forefoot. Analyzing from the cutoff values, the odds ratios of HVA, CPA, and HVA and (combined) CPA were 4.64, 1.73, and 2.99, respectively. Hallux valgus and flatfoot were related to callosities of the forefoot in RA. This study suggested that to prevent callosities of the forefoot, early diagnosis and foot care for hallux valgus and flatfoot are needed in daily practice.
我们旨在研究类风湿关节炎（RA）患者前足胼胝与足部畸形、健康评估问卷残疾指数（HAQ-DI）和改良总 Sharp 评分（TSS）的关系。共纳入 202 例患者和 404 只脚。我们检查了胼胝的患病率。临床数据包括 HAQ-DI、TSS、拇外翻角（HVA）和跟骨倾斜角（CPA）。通过比较有和没有前足胼胝的患者，分析与前足胼胝相关的因素。所有患者中胼胝的患病率为 31.2%，所有足部的患病率为 24.0%。有前足胼胝的患者足部 TSS 明显更高。胼胝的存在影响 HAQ-DI 行走评分。HVA 和 CPA 被确定与前足胼胝有关。从截止值分析，HVA、CPA 和 HVA 和（联合）CPA 的优势比分别为 4.64、1.73 和 2.99。拇外翻和扁平足与 RA 患者的前足胼胝有关。本研究表明，为预防前足胼胝，日常实践中需要早期诊断拇外翻和扁平足，并进行足部护理。
