The Relationship Between Foot Symptoms With Disease Activity And Functional State In Patients With Rheumatoid Arthritis

Author(s): Halime Kibar*, Derya Bugayci & Nurdan Paker

Aim: Foot and ankle joints are among the joints evaluated in Rheumatoid Arthritis (RA), but not for the calculation of Disease Activity Score-28 (DAS28). The aim of the study is to evaluate the frequency of foot complaints in RA patients and to investigate the relationship between DAS28 and foot complaints and functional statuses.

Method: DAS28 (with Erythrocyte Sedimentation Rate), Health Assessment Questionnaire (HAQ), Foot Function Index (FFI), Foot Function Index Pain subscale (FPI), Foot Function Index Deficiency subscale (FDI), Foot Function Index Limitation subscale (FLI), 6-meter (mt) walking time, Visual Analog Scale (VAS) are used to investigate the relationship between DAS28 and other index and scales.

Results: 103 patients with RA are included in the study. 91.3% of the patients are female and 8.7 % are male. 66% of the patients have foot and ankle complaints and 34% have no complaints. It is observed that DAS28 is correlated positively with VAS (p<0.001, r=0.702), HAQ (p<0.001, r=0.530 ), FPI (p<0.001, r=0.490 ), FLI (p=0.002, r=0.311 ), FDI (p<0.001, r=0.495 ), FFI (p<0.001, r=0.485 ), 6 mt walking time (p=0.049, r= 0.198) and Erythrocyte Sedimentation Rate (p<0.001, r=0.57) respectively . In addition, it is observed that FFI is correlated positively with duration of disease (p=0.015, r=0.226), body mass index (p=0.002, r=0.292), VAS (p<0.001, r=0.639), HAQ (p<0.001, r=0.376), 6 mt walking time ( p<0.001, r =0.551 ) and the Erythrocyte Sedimentation Rate ( p<0.001, r=0.247).

Conclusion: Foot complaints in patients with RA are seen at high rates. Despite the extent of the problem, the rheumatoid foot is neglected. Patients with foot complaints are more likely to have higher inflammatory levels and have more functional limitations. The DAS28 score can also be used for follow-up in patients with foot complaints. In addition, foot complaints must be questioned and clinical and functional follow-up should be done. FFI and subscores can be used in evaluating and following foot complaints in patients with RA.