Background: Rheumatoid arthritis (RA) is a systemic autoimmune polyarticular disease. Despite being commonly affected in RA, the ankle and foot do not receive much attention, particularly in early disease. The precise diagnosis of their involvement and its impact on health is a clinical challenge that requires accurate assessment.
Aim: To determine the role of ultrasound in evaluation of ankle and foot pathologies and assess its impact on functional activity in newly diagnosed RA patients.
Methods: The study was conducted on 152 RA patients and 52 healthy controls. Patients were subjected to history taking, clinical examination, and ultrasound scan. Impact on health was measured by health assessment questionnaire, as well as foot function index.
Results: In a cohort of patients with early RA with median duration of 1 month, tibialis posterior (TP) tenosynovitis (45.4%) was the most common pathology, followed by tibiotalar (TTJ) synovitis (39.8%), and peroneal tenosynovitis (39.1%). In terms of disease duration, TTJ (P = .001) foot pathologies were less common in early RA and tended to worsen over time, whereas TP (P = .048) and peroneal tenosynovitis (P = .011) were more common in early RA. In multivariate analysis TTJ, subtalar synovitis, forefoot pathologies, TP tenosynovitis, and Achilles enthesitis were found to be significant predictors of functional disability. The most important predictors of ankle pain were TTJ synovitis, TP tenosynovitis, peroneal tenosynovitis, and plantar fasciitis.
Conclusion: Ankle and foot involvement is a common issue of early RA, and it has a significant impact on quality of life. Ultrasound is a reliable tool for evaluating various abnormalities in this complex area, allowing for better management.
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http://dx.doi.org/10.1111/1756-185X.14426 | DOI Listing |
Medicina (Kaunas)
December 2024
Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, 84081 Salerno, Italy.
Soft tissue reconstruction in the lower limbs presents a significant challenge, particularly when addressing defects in the distal third of the leg, ankle, and foot. The reverse sural flap reliant on the perforating branches of the peroneal artery has emerged as a versatile option, offering a solution for patients for whom microsurgical techniques are not feasible. Despite its advantages, the procedure carries inherent risks, especially in populations with underlying conditions, such as venous insufficiency, cardiovascular disease, and diabetes, as well as in elderly patients, where the likelihood of flap necrosis is elevated.
View Article and Find Full Text PDFJ Clin Med
December 2024
Clinical Department No. 10, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Controlling pain after major orthopedic surgery may be challenging, and it is related to delayed recovery, the development of chronic pain, and analgesic dependence. It is well known that effective postoperative pain control can reduce hospital stays by ensuring a more rapid rehabilitation,thereby decreasing the overall costs. Despite the development of analgesics, the use of opioids and their derivates remains the cornerstone of treatment for patients with acute moderate-to-severe pain in association with general or regional anesthesia.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Orthopedics and Geriatric Sciences, Catholic University of the Sacred Heart, 00136 Rome, Italy.
: Foot and ankle injuries are one of the leading orthopedic causes of emergency department (ED) admissions. The purpose of this study was to analyze, through 5 years of data collection, differences in number and type of admissions, as well as the severity of foot and ankle trauma to the ED in the pre-pandemic period, during the COVID-19 emergency, and in the post-pandemic period. This study aims to assess epidemiological and clinical data.
View Article and Find Full Text PDFBioengineering (Basel)
December 2024
Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Toyoake 470-1192, Japan.
This study investigated the effects of ankle dorsiflexion angle adjustments in ankle-foot orthoses (AFOs) on the gait of healthy individuals. Fifteen healthy participants engaged in treadmill walking tasks while wearing AFOs with dorsiflexion angles set at 0°, 5°, 10°, and 15°. Three-dimensional treadmill gait analysis was used to collect data during treadmill walking.
View Article and Find Full Text PDFBioengineering (Basel)
December 2024
Division of Biomechatronics, Fraunhofer Institute for Manufacturing Engineering and Automation IPA, D-95447 Bayreuth, Germany.
Previous studies on gender differences in running biomechanics have predominantly been limited to joint angles and have not investigated a potential influence of footwear condition. This study shall contribute to closing this gap. Lower body biomechanics of 37 recreational runners (19 f, 18 m) were analysed for eight footwear and two running speed conditions.
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