RHEUMATOID-ARTHRITIS OF THE FOREFOOT

Severe and often debilitating involvement of the forefoot is seen freq uently in patients with rheumatoid arthritis. The combination of destr uctive synovitis and weight bearing leads to a spectrum of disorders c ausing pain, deformity, and eventual loss of function. In addition, ad vances in total knee and total hip arthroplasty have placed added impo rtance on preserving the ability of the foot and ankle to bear weight and allow functional ambulation. This article reviews the epidemiology , pathophysiology, clinical presentation, physical examination, and tr eatment of rheumatoid arthritis of the forefoot.