Erdem I H, Kanar M
Department of Physical Medicine and Rehabilitation, Basaksehir Cam Sakura City Hospital, Basaksehir, Istanbul, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Mar;27(5):1844-1851. doi: 10.26355/eurrev_202303_31547.
Foot problems are common clinical disorders in patients with Rheumatoid Arthritis (RA). The aim of this study was to investigate the frequency and impact of foot and ankle problems in patients with RA.
A total of 164 feet of 82 RA patients with a diagnosis of one year or more were evaluated. Deformities including HV, CT, SF, PC, PP, MPS, MPV, and HT were examined in all RA patients. The Foot Function Index was used to measure the impact of these deformities on pain, disability, and movement limitations. Radiological changes were measured using the modified Larsen score.
The frequency of deformity in RA patients was found to be 95.1%, with HV deformity being the most common at 84.1%. There was a statistically significant relationship between SF, HV, PP, and PC deformities and disease duration. In our sample of 82 patients, 70 (85.3%) reported past or present foot pain complaints. The most common site of pain was the ankle joint, with 44 (53.7%) patients experiencing ankle pain. A statistically significant increase in the frequency of ankle pain was found as DAS28 scores, body mass index (BMI), and disease duration increased. There was also a correlation between an increase in DAS28 scores and the frequency of forefoot pain. A significant correlation was found between MPV, HV, PP, and PC deformities and high FFI scores. Larsen radiological scores were not correlated with foot-ankle pain or duration of pain.
These findings suggest that foot deformities are common in RA, and it is important to address them early in the disease course to minimize functional disability and improve quality of life.
足部问题是类风湿关节炎(RA)患者常见的临床病症。本研究旨在调查RA患者足部和踝关节问题的发生率及影响。
对82例确诊一年及以上的RA患者的164只脚进行了评估。对所有RA患者检查了包括高弓足(HV)、槌状趾(CT)、拇外翻(SF)、跖骨头下沉(PC)、扁平足(PP)、跖趾关节半脱位(MPS)、跖趾关节外翻(MPV)和马蹄足(HT)在内的畸形情况。采用足部功能指数来衡量这些畸形对疼痛、残疾和活动受限的影响。使用改良的拉森评分来测量放射学变化。
发现RA患者的畸形发生率为95.1%,其中高弓足畸形最为常见,占84.1%。籽骨(SF)、高弓足(HV)、扁平足(PP)和跖骨头下沉(PC)畸形与病程之间存在统计学上的显著关系。在我们的82例患者样本中,70例(85.3%)报告有过去或现在的足部疼痛主诉。最常见的疼痛部位是踝关节,44例(53.7%)患者有踝关节疼痛。随着疾病活动度评分28(DAS28)、体重指数(BMI)和病程增加,踝关节疼痛的发生率有统计学上的显著增加。DAS28评分增加与前足疼痛的发生率之间也存在相关性。跖趾关节外翻(MPV)、高弓足(HV)、扁平足(PP)和跖骨头下沉(PC)畸形与高足部功能指数(FFI)评分之间存在显著相关性。拉森放射学评分与足踝关节疼痛或疼痛持续时间无关。
这些发现表明足部畸形在RA中很常见,在疾病病程早期对其进行处理以尽量减少功能残疾并改善生活质量很重要。