The Elusive but Painful Subtalar Joint in Rheumatoid Arthritis

Kaeley, Gurjit S.; Ranganath, Veena K.; Roth, Johannes

doi:10.3899/jrheum.181156

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…1). This observation is in accordance with recent reports based on modern imaging techniques, including MRI and Power Doppler Ultrasound, by which residual synovitis and increased vascularity have been reported in clinically quiescent joints (18,19).…”

Section: Discussionsupporting

confidence: 93%

Localization of surfactant protein‐D in the rheumatoid synovial membrane

Christensen

Sørensen

Junker³

et al. 2017

APMIS

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Surfactant protein-D (SP-D) is a collectin, which plays an important role in airway protection and inflammation. The molecule has both pro-and anti-inflammatory capacities depending on its molecular size. Its involvement in joint diseases is largely unknown and the aim of this investigation was to study SP-D occurrence and distribution in the synovial membrane of patients with long-standing rheumatoid arthritis (RA) and osteoarthritis (OA). Six RA patients and six OA patients, who underwent total hip arthroplasty, were included in the study. Synovial tissue biopsies were obtained during surgery and subsequently prepared for immunohistochemistry. In this first, small-scale comparative study on the occurrence of SP-D in the synovial membrane of RA and OA, we report that SP-D was only present in the microvascular endothelium in subsynovial and pannus tissue and that the immunostaining was much stronger than in OA. This distribution pattern suggests that SP-D modulates RA inflammatory activities.

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Section: Discussionsupporting

confidence: 93%

Localization of surfactant protein‐D in the rheumatoid synovial membrane

Christensen

Sørensen

Junker³

et al. 2017

APMIS

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“…Other non-traumatic causes include longstanding flat feet, tendon dysfunction and inflammatory conditions such as rheumatoid arthritis 9 . Following failure of non-operative management which includes the use of painkillers, ankle supports, and activity modification, the gold standard treatment for end stage subtalar joint arthritis at present consists in the removal of the subtalar joint and fusion of the talus to the calcaneus (subtalar joint fusion) using metalwork.…”

mentioning

confidence: 99%

Centre of Rotation of the Human Subtalar Joint Using Weight-Bearing Clinical Computed Tomography

Fernández

Hoxha

Chan

et al. 2020

Sci Rep

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Accurate in vivo quantification of subtalar joint kinematics can provide important information for the clinical evaluation of subtalar joint function; the analysis of outcome of surgical procedures of the hindfoot; and the design of a replacement subtalar joint prosthesis. The objective of the current study was to explore the potential of full weight-bearing clinical computed tomography (ct) to evaluate the helical axis and centre of rotation of the subtalar joint during inversion and eversion motion. A subject specific methodology was proposed for the definition of the subtalar joint motion combining threedimensional (3D) weight-bearing imaging at different joint positions with digital volume correlation (DVC). The computed subtalar joint helical axis parameters showed consistency across all healthy subjects and in line with previous data under simulated loads. A sphere fitting approach was introduced for the computation of subtalar joint centre of rotation, which allows to demonstrate that this centre of rotation is located in the middle facet of the subtalar joint. Some translation along the helical axis was also observed, reflecting the elasticity of the soft-tissue restraints. This study showed a novel technique for non-invasive quantitative analysis of bone-to-bone motion under full weight-bearing of the hindfoot. Identifying different joint kinematics in patients with ligamentous laxity and instability, or in the presence of stiffness and arthritis, could help clinicians to define optimal patient-specific treatments. The subtalar joint describes an articulation between talus and calcaneus, forming one of two joints of the hindfoot with the tibiotalar or ankle joint above the talus and the subtalar joint below. The talus comprises of three facets (anterior, middle and posterior) that articulate with the mating facets on the calcaneus at the subtalar joint. The bones are connected by a complex of ligamentous structures that connect the talus to the calcaneus and both structures to the adjacent navicular bone, which is intricately involved in hindfoot and midfoot motion (Fig. 1). The subtalar joint is the primary joint involved in motion and posture of the hindfoot in the frontal plane. Motion is complex and it combines dorsiflexion, abduction and eversion in one direction and plantarflexion, abduction and inversion in the other 1. Problems associated to the subtalar joint can have a significant impact on function 2 , preventing participation in sports and normal daily activities. Common pathologies affecting the joint include instability following ligamentous injury 3 , and painful flat feet in children and adults. In addition, end stage ankle and hindfoot arthritis is a major problem that has been shown to affect quality of life as much as end stage heart disease 4,5. Although the incidence of subtalar joint arthritis is unknown, approximately 3.4% of the population aged over 50 has radiographic hindfoot arthritis, which is more than 300,000 people in the UK 6. The most common cause of subtalar joint arthri...

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The Elusive but Painful Subtalar Joint in Rheumatoid Arthritis

Cited by 2 publications

References 10 publications

Localization of surfactant protein‐D in the rheumatoid synovial membrane

Localization of surfactant protein‐D in the rheumatoid synovial membrane

Centre of Rotation of the Human Subtalar Joint Using Weight-Bearing Clinical Computed Tomography

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