Objectives The aim of this study was to assess the type and frequency of foot deformities in rheumatoid arthritis (RA) patients, and to evaluate the impact of these deformities on Foot Function Index (FFI) and patient functional ability.
Methods We conducted a cross-sectional study in 71 Moroccan patients with a disease duration over than 2 years. Sociodemographic, clinical and biological data were collected. We examined the feet of all patients for hallux valgus (HV) and rigidus (HR), quintus varus (QV), cock-up deformity (CD), clawing toe (CT), mallet finger (MF), Blast of wind peroneal (BWP) and tibial (BWT), and we measured calcaneal valgus angle (CV). Function status of feet, capacity, and health status was evaluated by using FFI, Steinbrocker Functional Class (SFC) and the Arabic version of HAQ respectively. Structural damage was assessed by using the modified Sharp score in the feet.
Results 93% of patients were female. The mean age was 48.8±12.95 years old [22-82]. The mean disease duration was 10.59±8.34 years [2–35] and the mean score of DAS 28 was 5.3±1.8 [1.6-8.2]. Rheumatoid factor (RF) was positive in 80.3% of cases. Foot deformities were observed in 57 (80.3%) patients; HV (57.7%), CT (23.9%), CD (22.5%), BWP (21.1%), BWT (15.5%), HR (9.9%), QV (7%), MF (4.2%), CV (42.3%). Flat foot was found in 59.2% of cases and cavus foot in 21.1%. The mean of FFI score was 45.75±29.67 [0 – 98], of SFC was 2.15, of HAQ was 1.43 and the Scharp modified score was 14.91±11.83.
3 deformities were associated with the increase of disease duration: HV (p=0.001), HR and QV (p=0.01); HV was also correlated to RF (p=0.01). BWT was associated to FFI (p=0.04) and Sharp score (p=0.03). we did not find any correlation between deformities and HAQ.
SFC was correlated with HAQ, structural damage and activity of RA.
There was significant correlation between FFI and HAQ and high disease activity (p<0.0001), followed by clinical deformities, SFC and feet structural damage.
Conclusions Feet deformities are highly frequent in our RA patients. They may affect patient functional foot, especially BWT.
Disclosure of Interest None Declared
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