Elshony Hosna, Aly Mohamed H, Mohammed Abdelgaffar, Hassan Abdulrahman M, Alshehri Abdulrahman A, Hedak Mohamed, Almuhanna Rakan, Al-Ghamdi Abdulaziz, Elsaadawy Rasha
Neuropsychiatry Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt.
Internal Medicine Department, Security Forces Hospital, Makkah, Saudi Arabia.
Clin Neurophysiol Pract. 2025 Jul 23;10:316-323. doi: 10.1016/j.cnp.2025.07.003. eCollection 2025.
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.
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.
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.
Subclinical TTS is highly prevalent in RA and linked to systemic inflammation, disease severity, and structural damage.
Routine electrophysiological screening may enable early detection and intervention, preserving nerve function and improving long-term mobility and quality of life in RA patients.
The study was approved by the SFHM Institutional Review Board and registered under HAP-02-K-052 in August 2024.
评估类风湿关节炎（RA）患者无症状跗管综合征（TTS）的患病率及其与疾病活动度、炎症和电生理变化的关联。
40例RA患者和40例年龄及性别匹配的对照者接受了神经传导研究，评估足底内侧、足底外侧和胫后神经。记录疾病活动度（DAS28、RASS）、炎症标志物（ESR、CRP）和自身抗体（RF、抗CCP）。采用t检验进行比较；相关性分析评估关联。
RA患者的感觉潜伏期显著延长，波幅和神经传导速度降低，尤其是在足底内侧和外侧神经。感觉潜伏期对亚临床TTS的敏感性为100%；运动参数显示出高特异性。较高的DAS28、较长的病程、升高的ESR/CRP、关节畸形和血清阳性预示着TTS。
亚临床TTS在RA中高度流行，与全身炎症、疾病严重程度和结构损伤有关。
常规电生理筛查可能有助于早期发现和干预，保护神经功能，改善RA患者的长期活动能力和生活质量。
该研究经SFHM机构审查委员会批准，并于2024年8月在HAP-02-K-052下注册。
