FOOT AND ANKLE PROBLEMS IN RHEUMATOID-ARTHRITIS

The purpose of this study was to examine the prevalence of foot and an kle problems in 99 patients with clinically proven rheumatoid arthriti s. Patients were recruited from outpatient rheumatology clinics; no at tempt was made to select patients on the basis of the severity of thei r disease, duration of disease, or symptom constellation. Each patient was examined by an investigator utilizing a predesigned protocol to a ssess their functional status, functional capacity, and overall joint involvement. Ninety-three of 99 patients had complaints referable to t he foot or ankle at some time since diagnosis of rheumatoid arthritis. Ankle problems were paramount in 42%, forefoot difficulties in 28%, a nd equal ankle and forefoot problems in another 14%. Only four patient s had had any treatment involving foot orthotic devices or special sho e wear. The prevalence of foot and ankle symptoms was related to the d uration of systemic illness, but was present in > 50% of patients at a ny time after diagnosis of rheumatoid arthritis. Patients with longsta nding rheumatoid arthritis have a high prevalence of foot and ankle sy mptoms. Unlike previous reports, the present study found a high preval ence of ankle and hindfoot symptoms, as opposed to forefoot complaints . Despite this finding, the patients had been treated infrequently by either conservative nonoperative management directed at accommodating footwear or surgical intervention to favorably alter their foot and an kle mechanics.