Features of patients with rheumatoid arthritis whose debut joint is a foot or ankle joint: A 5,479-case study from the IORRA cohort

Abstract

BackgroundFoot and ankle joint disorders are serious issues for patients with rheumatoid arthritis (RA). We compared the differences between patients with RA whose first symptom involved a foot or ankle joint (FOOT group) versus other joints (non-FOOT group) within the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) cohort in our institute.Patients and methodsIn the IORRA survey conducted in April 2016, patients were invited to complete six questionnaires about their first symptom at RA onset, current foot or ankle symptoms, daily living activities, and mental health. Disease activity, clinical laboratory variables, functional disability, quality of life, use and ratio of anti-inflammatory and antirheumatic drugs, daily living activities and mental health were compared between the two groups.ResultsAmong 5,637 Japanese patients with RA who participated in the IORRA survey on April 2016, 5,479 (97.2%) responded to the questionnaire regarding their debut joint. Of these patients, 2,402 (43.8%) reported that their first symptom of RA involved a foot or ankle joint. The FOOT group (n = 2,164) had higher disease activity, higher disabilities, lower quality of life, lower activities of daily living, and poorer mental health and used anti-inflammatory drugs at a higher rate and at higher doses compared with the non-FOOT group (n = 2,164). On the other hand, the use of medications to suppress the disease activity of RA was similar between the groups.ConclusionClinicians should pay more attention to foot and ankle joints in daily practice so as not to underestimate the disease activity of RA.

Do ankle, hindfoot, and heel ultrasound findings predict the symptomatology and quality of life in rheumatoid arthritis patients?

“…Rheumatoid arthritis (RA) is a chronic and progressive systemic disease that leads progressively to joint damage and disability ( 1 , 2 ) . Approximately half of patients with RA report foot or ankle joints symptoms as the first manifestation of the disease ( 3 , 4 ) , and in time 71% of these patients develop walking disability ( 5 ) .…”

“…The quality of life (QoL) in RA patients is poorer compared to the general population, and even lower in those with foot involvement, especially regarding mobility, functionality, daily activities, and mental health ( 3 , 6 ) . The involvement of the hindfoot (talonavicular [TN] and subtalar [ST] joints) is associated with functional disability and walking difficulties ( 7 ) .…”

Measures of Foot Pain, Foot Function, and General Foot Health

“…For adults aged older than 55, the foot/ankle is the third most common site of self‐reported joint pain, following the knee and the hand/wrist . In a rheumatology setting, 64% to 93% of patients with inflammatory arthritis self‐report experiencing foot pain that is moderate to severe , and patients with rheumatoid arthritis whose debut joint is a foot/ankle joint experience higher disease activity, higher disability, and lower quality of life . Given the common presentation and significant impact of musculoskeletal symptoms involving the foot and ankle, valid and reliable patient‐reported outcome measures can improve assessment and management.…”

Effect of an orthosis on foot center of pressure translation for treatment of hallux valgus in patients with rheumatoid arthritis: A report of 17 cases

“…Foot impairment is a major adverse condition in rheumatoid arthritis (RA), and >90% patients with RA have reported foot complaints during the course of the disease 1, 2, 3. Foot problems can lead to reduced walking distance and activity levels and impaired health-related quality of life 4, 5, 6.…”