Foot problems are more prevalent in rheumatoid arthritis (RA) than previously reported

Background: Foot pathology is thought to be common in RA. However, most
epidemiological studies that have included the feet have reported the findings of
clinical examination of the feet and/or radiological assessment. We set out to
explore the symptoms of foot involvement among patients with RA from the
patients’ perspective.
Methods: A 28-item self-administered questionnaire was sent to all RA patients
registered with the National Rheumatoid Arthritis Society (NRAS). The questionnaire enquired about symptoms of foot pain, stiffness and sensory disturbance and assessed the anatomical distribution of symptoms according to validated mannequins.
Results: In total, 650 questionnaires were sent and 395 (61%) useable replies
were received. Almost all (99.97%) respondents reported experiencing foot pain atsome time during their disease. Most (93%) reported suffering recurrent, moderateto severe foot pain on a daily basis. Other symptoms including stiffness, numbnessand swelling were also common (80%, 41% and 80%, respectively). All parts of the feet are affected but the metatarsophalangeal and ankle joints were reported to be particularly troublesome.
Conclusions: Symptoms in the feet in RA are common, severe and tend to be
under-reported by clinicians. The involvement of the metatarsophalangeal joints
and ankles is frequent and troublesome. This finding has important implicatons, as these joints are vital for normal propulsive gait, without which may lead to reduced mobility and a loss of independence.