Asymptomatic tarsal tunnel syndrome in rheumatoid arthritis: An electrophysiological perspective with Insights into clinical and Laboratory correlates.

OBJECTIVE

To evaluate the prevalence of asymptomatic tarsal tunnel syndrome (TTS) in rheumatoid arthritis (RA) patients and its association with disease activity, inflammation, and electrophysiological changes.

METHODS

Forty RA patients and 40 age- and sex-matched controls underwent nerve conduction studies assessing medial plantar, lateral plantar, and posterior tibial nerves. Disease activity (DAS28, RASS), inflammatory markers (ESR, CRP), and autoantibodies (RF, anti-CCP) were recorded. Comparisons used t-tests; correlations assessed associations.

RESULTS

RA patients showed significantly prolonged sensory latencies and reduced amplitudes and nerve conduction velocities, especially in medial and lateral plantar nerves. Sensory latencies had 100% sensitivity for subclinical TTS; motor parameters demonstrated high specificity. Higher DAS28, longer disease duration, elevated ESR/CRP, joint deformities, and seropositivity predicted TTS.

CONCLUSIONS

Subclinical TTS is highly prevalent in RA and linked to systemic inflammation, disease severity, and structural damage.

SIGNIFICANCE

Routine electrophysiological screening may enable early detection and intervention, preserving nerve function and improving long-term mobility and quality of life in RA patients.

TRIAL REGISTRATION

The study was approved by the SFHM Institutional Review Board and registered under HAP-02-K-052 in August 2024.