Background Forefoot deformity is one of the most dominant deformities in patients with rheumatoid arthritis (RA). However, the prevalence, degree, contributing factors and influence on daily activity are not well understood. We conducted a cross-sectional study on this subject using a comprehensive RA cohort (KURAMA cohort).
Objectives To investigate the prevalence, contributing factors and the influence of daily activity of forefoot deformities from a RA cohort.
Methods Surveillance was performed on 740 feet of 370 patients with RA in KURAMA cohort. The average age was 62.9 years old, and the female ratio was 87.6%. The statistical analyses were conducted using demographic data such as age, gender, the duration of disease, disease activity, and functional activity, and radiological measurements such as hallux valgus angle, metatarsal deformities (M1M2 angle), Larsen grade of metatarsophalangeal joints (MTP joints) and dislocation of the MTP joints.
Results Hallux valgus deformity was found in 47%, and severe deformity (40°<HV angle) was in 13% of patients. Severe spread foot was found in 10%. Joint destruction evaluated by Larsen grade was found in 34%, 26%, 24%, 24%, and 30% of the first to the fifth MTP joint, respectively. Joint dislocation was found 13%, 8%, 8%, 5%, and 10% of the first to the fifth MTP joint, respectively. The presence of forefoot deformities was significantly associated with the duration of the disease (p=0.003), but not with age, gender, medication and disease activity at the time of surveillance. Moreover, the presence of forefoot deformities was significantly associated with functional activity (HAQ) (p=0.005). Found was 30% of patients with two or more MTP joint destruction despite of no or slight deformity of both wrist joints.
Conclusions We found a high prevalence of forefoot deformities in patients with RA. The dominance of forefoot deformities compared with the wrist joint was found 30% of patients, and the deformities was associated with functional activities.
Disclosure of Interest None declared
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