Dr. Mielants has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from MSD, Pfizer, and AstraZeneca.
Quantitative assessment of foot structure in rheumatoid arthritis by a foot digitizer: Detection of deformities even in the absence of erosions
Article first published online: 27 OCT 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 11, pages 1641–1648, November 2012
How to Cite
De Mits, S., Mielants, H., De Clercq, D., Woodburn, J., Roosen, P. and Elewaut, D. (2012), Quantitative assessment of foot structure in rheumatoid arthritis by a foot digitizer: Detection of deformities even in the absence of erosions. Arthritis Care Res, 64: 1641–1648. doi: 10.1002/acr.21794
- Issue published online: 27 OCT 2012
- Article first published online: 27 OCT 2012
- Accepted manuscript online: 17 JUL 2012 12:46PM EST
- Manuscript Accepted: 27 JUN 2012
- Manuscript Received: 29 FEB 2012
Foot involvement is a major feature in rheumatoid arthritis (RA), leading to structural deformities. Methods to allow a 3-dimensional (3-D) evaluation of foot structure in RA to be applicable in daily clinical practice have not been evaluated. This study assessed the use of a foot digitizer, a noninvasive 3-D scanner collecting objective quantitative data of the feet, to evaluate the presence of foot structure abnormalities in an RA outpatient cohort.
Foot digitizer data of RA patients were compared with healthy controls. Subanalyses were performed to find relationships with erosive disease and the presence of swollen and/or tender joints. Linear mixed models were applied with correction, including sex, age, body weight and height, foot length, Disease Activity Score in 28 joints, and disease duration.
Forty-one percent of the patients showed >1 abnormal parameter, measured with the 3-D foot scanner. Most differences found were located in the forefoot, the most frequently affected area of the RA foot. Strikingly, even in the absence of joint erosions, marked alterations were found. Comparable differences were also observed between the patients with and without swollen and/or tender joints. Additionally, alterations were not strongly related to foot pain and disability, suggesting the capacity of the foot digitizer to detect early changes in foot structure.
The results highlight the impact of RA on foot structure, even in the absence of clinical signs of swelling or radiographic erosions. The foot digitizer offers a valuable tool to screen for such foot deformities before the presence of erosions.