Abdalla Ahmed M, Aziz Yasser A, Mandl Peter, Mahgoub Marwa Y
Rheumatology, Rehabilitation and Physical Medicine Department, Benha University, Banha, Egypt.
Division of Rheumatology, Internal Medicine 3 Department, Medical University of Vienna, Vienna, Austria.
Clin Rheumatol. 2025 Jul;44(7):3025-3032. doi: 10.1007/s10067-025-07503-y. Epub 2025 Jun 9.
The ankle and foot joints are frequently affected by rheumatic and musculoskeletal disorders (RMDs) at all ages, causing pain and limited movement. Ultrasound (US) is an effective tool for assessing soft tissue and monitoring patients with inflammatory and degenerative RMDs.
To examine the frequency and classifications of soft tissue lesions, including tenosynovitis, tendon injuries, and ligament damage, as well as synovitis in the ankle and foot, clinically and with ultrasound evaluation in patients presenting associated symptoms.
A cross-sectional study at two centers of rheumatology, including clinical examination of patients with ankle and/or foot complaints. Ultrasound evaluation included B-mode gray scale, and power Doppler was done. Functional assessment of ankle and foot was performed by the Foot Function Index.
A study of 200 ankles and feet were examined in100 patients with rheumatoid arthritis (34%), spondylarthritis (23%), and undiagnosed cases (16%). Joints were more affected than tendons or ligaments, notably the metatarsophalangeal (83%), talonavicular (63%), subtalar (46%), and tibiotalar (35%) joints. The Achilles tendon was most affected in both rheumatoid arthritis and spondylarthritis patients.
Subclinical diagnosis and differentiation using ultrasound for ankle and foot pathologies were proven and correlated significantly with patients' function and disability. Key Points • Musculoskeletal US has a beneficial effect in the evaluation of ankle and foot complaints. • The physical activity is severely impacted by the ankle-foot manifestations.
踝关节和足部关节在各年龄段均常受风湿性和肌肉骨骼疾病（RMDs）影响，导致疼痛和活动受限。超声（US）是评估软组织以及监测炎症性和退行性RMDs患者的有效工具。
通过临床检查及超声评估，检查出现相关症状的患者踝关节和足部软组织病变（包括腱鞘炎、肌腱损伤和韧带损伤）以及滑膜炎的发生率和分类。
在两个风湿病中心进行横断面研究，包括对踝关节和/或足部有症状患者的临床检查。超声评估包括B型灰阶成像，并进行了能量多普勒检查。通过足部功能指数对踝关节和足部进行功能评估。
对100例类风湿关节炎患者（34%）、脊柱关节炎患者（23%）和未确诊病例（16%）的200个踝关节和足部进行了研究。关节比肌腱或韧带受影响更严重，尤其是跖趾关节（83%）、距舟关节（63%）、距下关节（46%）和胫距关节（35%）。在类风湿关节炎和脊柱关节炎患者中，跟腱受影响最为严重。
超声对踝关节和足部病变的亚临床诊断和鉴别诊断得到证实，且与患者的功能和残疾程度显著相关。要点 • 肌肉骨骼超声在评估踝关节和足部症状方面具有有益作用。 • 踝关节和足部的表现严重影响身体活动。
