Deformation of the adult rheumatoid rearfoot. A radiographic study

Bouysset, M.; Tébib, Jacques; Weil, G.; Lejeune, E; Bouvier, Michel

doi:10.1007/bf02330591

Cited by 16 publications

(9 citation statements)

References 10 publications

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“…The reported prevalence of adult‐acquired pes planovalgus deformity in patients with rheumatoid arthritis (RA) is 46–64% (1–4). This condition is associated with significant localized pain and gait dysfunction and is difficult to treat, both conservatively and surgically (5–7).…”

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confidence: 99%

“…Pes planovalgus is a clinical description of 1 or more geometric features, including loss of arch height, abduction of the forefoot, and valgus of the rearfoot (1, 2, 5). Radiologically, pes planovalgus has been defined when standardized angles, such as the talocalcaneal angle of Kite, are above normal limits (3–5). The tarsal joints are relatively small and form complex structures, which have been shown to be vulnerable to the pathologic changes associated with persistent synovitis in RA (6, 8–10).…”

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confidence: 99%

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The geometric architecture of the subtalar and midtarsal joints in rheumatoid arthritis based on magnetic resonance imaging

Woodburn¹,

Udupa²,

Hirsch³

et al. 2002

Arthritis & Rheumatism

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Objective. To compare in vivo the 3-dimensional (3-D) geometric architecture of the subtalar and midtarsal joints in normal and rheumatoid arthritic (RA) feet, using magnetic resonance imaging (MRI) analysis.Methods. MRI was performed on 23 patients with RA, all of whom had disease activity in the subtalar and/or midtarsal joints. Image processing techniques were used to create 3-D reconstructions of the calcaneus (C), cuboid (c), navicular (N), and talus (T) bones. Twenty-four standard architectural parameters were measured from the reconstructions and were compared with data from 10 normal subjects. These parameters defined both 3-D distance and angular relationships among the 4 bones studied. Pattern classification techniques were used to establish a geometric architecture foot profile for the RA patients. The degree of individual patient fit to the new RA foot profile and to profiles for normal, pes planus, and pes cavus foot types was derived. Logistic regression was used to examine the relationship of foot architecture to inflammatory disease characteristics and physical examination variables.Results. Subtalar or midtarsal pain was reported by all 23 patients, and 22 of the 23 patients presented with >1 clinical feature of pes planovalgus deformity. In 21 patients, ultrasonography revealed synovitis at >1 tarsal joint or surrounding tendon. In the RA group, the normalized distances between the geometric centroids were significantly closer for bone pairs Cc and cT and significantly distracted for bone pair CN compared with the distances in normal subjects. In RA patients (versus normal subjects), the angles subtended at the bone centroids were significantly decreased in 3 bone groups (CNc, TCN, and TNc) and significantly increased in 3 bone groups (CcN, CcT, NTc). The angles formed between the major principal axes of bone pairs CT and cT were significantly increased in RA patients compared with those in normal subjects. Pattern classification defined 11 RA feet as having normal structure and 12 as having abnormal structure. However, the abnormal feet did not fit consistently with structures defined for RA, pes planus, or pes cavus foot types. Logistic regression demonstrated that subtalar joint synovitis was the only predictive factor for abnormal subtalar and midtarsal architecture (odds ratio 19.2, 95% confidence interval 1.77-200.0).Conclusion. This unique 3-D MRI-based technique successfully quantified the effects of RA on the geometric architecture of the foot and the patientspecific nature of these changes. This technique can be used to provide logical therapy for correction.

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The geometric architecture of the subtalar and midtarsal joints in rheumatoid arthritis based on magnetic resonance imaging

Woodburn¹,

Udupa²,

Hirsch³

et al. 2002

Arthritis & Rheumatism

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“…Das Talonavikulare-Gelenk ist mit 39% in unserer Untersuchung entsprechend den Werten von Bouysset, Vainio und Ljung ebenso ha Èufig befallen und stellt somit das am sta Èrksten befallene Einzelgelenk des Ru Èckfuûes dar (2,11,22). Bouysset beschreibt eine Progression der Vera Ènderungen im Talonavikulare Gelenk innerhalb von fu Ènf Jahren von 1,3% auf 19,6% und nach weiteren fu Ènf Jahren auf 44,7% (2).…”

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Progression von Fußdeformitäten bei rheumatoider Arthritis - Eine radiologische Verlaufsbeobachtung über fünf Jahre

Haas¹,

Kladny²,

Lott³

et al. 1999

Zeitschrift f�r Rheumatologie

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“…Painful foot is likely to flatten in RA [1] and it is obvious that hindfoot deformity is associated with functional limitation of the rheumatoid patient [4][5][6]. Foot orthoses have been reported to decrease foot deformities, pain, and disability in patients with rheumatoid arthritis [2,7].…”

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confidence: 99%

Is cavus foot affected by midfoot flattening in rheumatoid arthritis?

et al. 2010

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Objective: The painful feet are likely to flatten in rheumatoid arthritis (RA), and there is an optimal time to prescribe plantar orthoses in rheumatoid arthritis to correct deformity of the subtalar joint complex. We aimed to determine which type of foot is likely to become flattened to improve localized treatment of the rheumatoid foot. Methods: Three hundred and two rheumatoid feet (RF) in 151 patients with RA were compared with 200 feet in 100 consecutive patients with neck pain (control group, CF). The two groups were homogeneous for sex, age, and laterality of the foot. Lateral weight-bearing radiographs were obtained for each foot. Feet were classified as cavus, normal, and flat according to their angular variations. Results: On radiographs in weight-bearing, the frequency of cavus foot was similar in both groups regardless of age, before and after age 50 years. The frequency of normal foot was slightly lower in rheumatoid than in control feet (P = 0.036), while flat foot was much more frequent in rheumatoid feet (P = 0.0005). The frequency of flat foot increased significantly with age in both groups, and this increase occurred earlier in the RF group (P = 0.05). Intragroup comparison showed that the frequency of flat foot was higher after age 50 in both the RF (P = 0.026) and the CF (P = 0.002) group, and in the CF group, the increase of flat foot was more marked after 50 years than in the RF group. Conclusion: On the whole, the cavus foot did not flatten in RA or flattens less. Preventive plantar orthoses and appropriate footwear are therefore particularly indicated in the painful "normal" RF to avoid flat foot and in painful flat RF to avoid worsening of the flat foot.

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Deformation of the adult rheumatoid rearfoot. A radiographic study

Cited by 16 publications

References 10 publications

The geometric architecture of the subtalar and midtarsal joints in rheumatoid arthritis based on magnetic resonance imaging

The geometric architecture of the subtalar and midtarsal joints in rheumatoid arthritis based on magnetic resonance imaging

Progression von Fußdeformitäten bei rheumatoider Arthritis - Eine radiologische Verlaufsbeobachtung über fünf Jahre

Is cavus foot affected by midfoot flattening in rheumatoid arthritis?

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