The relevance of large-vessel vascular disease and restricted ankle movement to the aetiology of leg ulceration in rheumatoid arthritis

Leg ulceration in rheumatoid arthritis (RA) without systemic vasculitis is a difficult clinical problem and a common cause of morbidity. We have asses sed venous function, arterial pressures and range of ankle movement in 23 R A patients with a leg ulcer and compared the results with those in the non- ulcerated contralateral limb and in 25 RA patients matched for age and dura tion of arthritis. We found evidence of venous insufficiency in RA ulcer pa tients compared to disease controls. Ankle movement was more restricted in the ulcerated limb compared to the non-ulcerated contralateral leg. There w as no difference in large-vessel arterial function between groups. These fi ndings have implications for therapy and rates of healing.