RESEARCH - Prevalence and course of forefoot impairments and walking disability in the first eight years of RA

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Arthritis Rheum. 2008 Oct 30;59(11):1596-1602.

Prevalence and course of forefoot impairments and walking disability

in the first eight years of rheumatoid arthritis.

Leeden MV, Steultjens MP, Ursum J, Dahmen R, Roorda LD, Schaardenburg

DV, Dekker J.

Jan van Breemen Institute, Amsterdam, The Netherlands.

OBJECTIVE: To evaluate the prevalence and 8-year course of forefoot

impairments and walking disability in patients with rheumatoid

arthritis (RA).

METHODS: A total of 848 patients with recent-onset RA from 1995

through the present were included. The patients were assessed

annually. Pain and swelling of the metatarsophalangeal (MTP) joints,

erosions and joint space narrowing of the MTP joints and first

interphalangeal joints, and the Health Assessment Questionnaire

walking subscale were analyzed using descriptive and correlational

techniques.

RESULTS: Pain and swelling of >/=1 MTP joint was present in 70% of

patients at baseline, decreasing to approximately 40-50% after 2

years. The forefoot erosion score was >/=1 in 19% of the patients at

baseline, and the prevalence of forefoot erosion increased to

approximately 60% after 8 years, during which the mean forefoot

erosion score increased from 1.3 to 7.9. At least mild walking

disability was present in 57% of patients at baseline, stabilizing at

approximately 40% after 1 year.

CONCLUSION: The prevalence rates for pain and swelling of the MTP

joints and walking disability are initially high and then stabilize,

but the prevalence and severity of forefoot joint damage increase

during an 8-year course of RA. The findings of this study

quantitatively emphasize the importance of forefoot involvement in

patients with RA.

PMID: 18975350

http://www.ncbi.nlm.nih.gov/pubmed/18975350

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