A 20-YEAR FOLLOW-UP-STUDY OF SUBTALAR CHANGES IN RHEUMATOID-ARTHRITIS

The destruction of the subtalar joints in 103 seropositive RA patients with recent (less than or equal to 6 months) disease was evaluated ra diographically in a prospective follow-up study at onset and at 1, 3, 8, 15, and 20 years from entry. A total of 83 patients attended the 15 -year follow-up and 68 the 20-year follow-up. The Larsen grades of the joints were evaluated and the need for surgical treatment considered. At the 15-year follow-up the mean Larsen grade was 1.2 (median 0) and at the 20-year follow-up 1.3 (median 0): at the 20-year follow-up 77 subtalar joints were still assessed as Larsen grade 0. In this series, subtalar fusions were performed in 12 patients only, Spontaneous fusi ons occurred in 5 hindfeet in 3 patients. The destruction rate of the subtalar joint was loner than in previous retrospective or cross-secti onnl studies, The need for routine radiographs of ankles in RA patient s is questioned.