Patterns of foot complaints in systemic lupus erythematosus: a cross sectional survey

Abstract

BackgroundFoot complaints are common in inflammatory arthropathies such as rheumatoid arthritis and cause considerable disability. However, little is published about the nature and extent of foot complaints in systemic lupus erythematosus (SLE). We aimed to explore foot complaints among people with (SLE) and to evaluate the associations between foot pain and self-reported activities of daily living and well-being.MethodsWe developed and tested a new 40-item item self-administered questionnaire, using a five-stage development process utilising patient involvement throughout to ensure face and content validity. The self-administered instrument was posted to 406 people with SLE attending adult rheumatology clinics across three health boards in Auckland, New Zealand. The questionnaire enquired about symptoms of foot pain, extra-articular features, anatomical distribution of symptoms according to validated foot-mannequins and the impact of foot symptoms on activities of daily living and well-being.ResultsIn total, 406 questionnaires were posted, with 131 responses (response rate 32 %). We found 89 % were women, mean (SD) age 51 (15) years, mean (SD) diagnosis 12.5 (11.1) years. Overall, 77 % of those responding to the questionnaire reported foot pain during their SLE, with 45 % reporting current foot pain. All regions of the feet were affected, with the hindfoot (32 %) and ankles (30 %) most troublesome. The most common self-reported extra-articular foot complaints were cold feet, swelling and numbness. Almost two-thirds (61 %) reported foot pain adversely affected their lives; foot pain prevented sleeping in 36 % and had a negative effect on emotions for 33 %. Only 33 % of participants had seen a podiatrist. Significant association was found between foot pain and standing longer than 15 min (p < 0.001), walking (p < 0.001), climbing stairs (p < 0.001) and going shopping (p < 0.001). Pain was the primary symptom to affect quality of life (47/100).ConclusionFoot complaints in SLE are heterogeneous in nature, and may have a substantial negative impact on patient well-being. Foot complaints need to be addressed to reduce the burden of SLE and our findings support the need for wider access to specific foot care services.Electronic supplementary materialThe online version of this article (doi:10.1186/s13047-016-0143-8) contains supplementary material, which is available to authorized users.

Characteristics of footwear worn by people with systemic lupus erythematosus: a comparison with age‐ and sex‐matched healthy controls: a pilot study

“…Interestingly, people with SLE also rated their footwear as being less suitable and less comfortable compared to control participants. This may reflect the difficulty that people with SLE have in wearing different shoes [ 11 ]. A recent survey found that 27% of people with SLE reported that they would like to receive footwear advice, while 23% reported having received advice related to footwear [ 10 ].…”

“…In fact, female patients with rheumatoid arthritis choose not to wear specialist therapeutic footwear due to the associated restrictions in clothing and contribution to social isolation [ 18 ]. In a recent survey, 52% of people with SLE reported difficulty wearing different shoes [ 11 ]. A subjective global podiatric assessment of footwear found that 48% of people with SLE wore shoes deemed as ‘inappropriate’, compared with 35% of control participants [ 8 ].…”

Development of a national survey on foot involvement among people with psoriatic arthritis in Australia using a best practice approach: A survey development protocol

“…Although New Zealand has a smaller general population than Australia, based on these existing published sample sizes [50,51], the current study survey response of PsA-speci c participants exceeded previous target samples by a substantial degree. Of the 43 participants who did not progress beyond the rst information page to enter the survey, a proportion may have been other researchers, health professionals and administrators promoting the study that previewed the online survey and inadvertently contributed to the number of non-completions.…”

“…The total target population was estimated from the major sites for dissemination to be 6000 people with PsA (10% response rate). Similar New Zealand-based podiatry surveys received 197 web-survey completions from people with in ammatory arthritis (49% response rate, n = 400 target sample) [50] and 131 postal survey completions (32% response rate, n = 400 target sample) were received from people with systemic lupus erythematous [51].…”

Categorisation of foot complaints in systemic lupus erythematosus (SLE) from a New Zealand cohort

“…Recent studies have reported that foot involvement in SLE is heterogeneous and has a substantial negative impact on participants’ mobility, quality of life and well-being [3, 4]. In people with SLE, high levels of clinical and ultrasound-detected inflammatory joint abnormalities have been reported in the foot [5–7].…”