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Multidisciplinary approach in the treatment of tendinous foot involvement in rheumatoid arthritis



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Macarrón Pérez, Pilar and Morales Lozano, María del Rosario and Vadillo Font, Cristina and Abásolo Alcázar, Lidia and Martínez Rincón, Carmen and Fernández Gutiérrez, Benjamin and Blanco Hontiyuelo, Margarita and González-Fernández, María Luz (2021) Multidisciplinary approach in the treatment of tendinous foot involvement in rheumatoid arthritis. Clinical Rheumatology, 40 (12). pp. 4889-4897. ISSN 0770-3198

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Official URL: https://doi.org/10.1007/s10067-021-05848-8


Introduction: Patients with rheumatoid arthritis frequently consult for pain resulting from involvement of the tendons of the foot. This pain negatively afects foot biomechanics and quality of life. The most widely used treatment option for this condition is ultrasound-guided steroid injection, while other treatments were recommended such as heel pad, splints, and footwear.

Objective: To evaluate a joint intervention (rheumatology and podiatry) comprising an orthotic-podiatric treatment and infltrations. We evaluated the response using ultrasound monitoring, a pain scale, functional tests, and assessment of patient satisfaction.

Methods: We performed a non-controlled blinded prospective interventional study of 96 patients with foot pain and selected those with ultrasound-confrmed tendon involvement. Patients enrolled started intervention treatment and were followed for 6 months. The outcome of the intervention was compared with the patient’s baseline status. The pre-post diferences in the secondary variables (pain, disability) were analyzed using the t test and contingency tables or the Mann–Whitney test.

Results: Using our protocol, we recorded a rapid and signifcant reduction in the intensity of pain, in the foot function index, and in the ultrasound parameters (grayscale and Doppler). Structural damage to the tendon improved more slowly, with signifcant outcomes only at the last visit with respect to baseline. Abnormal foot support was detected in 50% of patients, and 79.5% were using inappropriate footwear.

Conclusions: Our multidisciplinary therapeutic protocol enabled a very signifcant improvement in tendon involvement. It was well-tolerated, with a high degree of satisfaction, and was easily evaluated using ultrasound. No changes in background medication were necessary.

Item Type:Article
Additional Information:

CRUE-CSIC (Acuerdos Transformativos 2021)

Uncontrolled Keywords:Orthotic-podiatric treatment, Posterior tibial tendinitis, Rheumatic foot, Ultrasonography
Subjects:Medical sciences > Medicine > Rheumatology
Medical sciences > Nursing > Podiatry
ID Code:70239
Deposited On:09 Feb 2022 11:45
Last Modified:18 Feb 2022 09:24

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