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Rheumatoid Arthritis of Ankle and Foot
Eva M. Escobedo, MD; B. J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Imaging

    • Clinical Issues

      • Diagnostic Checklist

        TERMINOLOGY

        • Abbreviations

          • Rheumatoid arthritis (RA)
        • Definitions

          • Chronic progressive systemic inflammatory disease in which joints are primary target

        IMAGING

        • General Features

          • Imaging Recommendations

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Andersson ML et al: Distribution of erosions in hands and feet at the time for the diagnosis of RA and during 8-year follow-up. Clin Rheumatol. 40(5):1799-810, 2021
                                          2. Dakkak YJ et al: Rheumatoid arthritis and tenosynovitis at the metatarsophalangeal joints: an anatomic and mri study of the forefoot tendon sheaths. Radiology. 295(1):146-54, 2020
                                          3. Bruyn GAW et al: Ultrasound of subtalar joint synovitis in patients with rheumatoid arthritis: results of an OMERACT reliability exercise using consensual definitions. J Rheumatol. 46(4):351-9, 2019
                                          4. Harman H et al: Ankle pathologies in patients with inflammatory rheumatic diseases: a clinical and ultrasonographic study. Int J Rheum Dis. 20(6):675-84, 2017
                                          5. Nieuwenhuis WP et al: Evaluation of the diagnostic accuracy of hand and foot MRI for early rheumatoid arthritis. Rheumatology (Oxford). 56(8):1367-77, 2017
                                          6. Toyota Y et al: Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis. Mod Rheumatol. 27(3):425-9, 2017
                                          7. Zubler V et al: Frequency of arthritis-like MRI findings in the forefeet of healthy volunteers versus patients with symptomatic rheumatoid arthritis or psoriatic arthritis. AJR Am J Roentgenol. 208(2):W45-53, 2017
                                          8. Naredo E et al: Predictive value of Doppler ultrasound-detected synovitis in relation to failed tapering of biologic therapy in patients with rheumatoid arthritis. Rheumatology (Oxford). 54(8):1408-14, 2015
                                          9. Niki H et al: Long-term outcome of joint-preserving surgery by combination metatarsal osteotomies for shortening for forefoot deformity in patients with rheumatoid arthritis. Mod Rheumatol. 25(5):683-8, 2015
                                          10. Onodera T et al: A comparative study with in vitro ultrasonographic and histologic grading of metatarsal head cartilage in rheumatoid arthritis. Foot Ankle Int. 36(7):774-9, 2015
                                          11. Matsumoto T et al: Radiologic patterning of joint damage to the foot in rheumatoid arthritis. Arthritis Care Res (Hoboken). 66(4):499-507, 2014
                                          12. Stomp W et al: Are rheumatoid arthritis patients discernible from other early arthritis patients using 1.5T extremity magnetic resonance imaging? A large cross-sectional study. J Rheumatol. 41(8):1630-7, 2014
                                          13. Chan PS et al: Natural history and imaging of subtalar and midfoot joint disease in rheumatoid arthritis. Int J Rheum Dis. 16(1):14-8, 2013
                                          14. Bøyesen P et al: Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients. Ann Rheum Dis. 70(1):176-9, 2011
                                          15. Aletaha D et al: 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 62(9):2569-81, 2010
                                          16. Narváez JA et al: MR imaging of early rheumatoid arthritis. Radiographics. 30(1):143-63; discussion 163-5, 2010
                                          17. Grondal L et al: The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients. Acta Orthop. 79(2):257-61, 2008
                                          18. Hattori T et al: Radiological study of joint destruction patterns in rheumatoid flatfoot. Clin Rheumatol. 27(6):733-7, 2008
                                          19. Torikai E et al: Comparison between resection arthroplasty alone and resection arthroplasty with arthrodesis of the first MTP joint for rheumatoid forefoot deformities. Mod Rheumatol. 18(5):486-91, 2008
                                          20. Wakefield RJ et al: The optimal assessment of the rheumatoid arthritis hindfoot: a comparative study of clinical examination, ultrasound and high field MRI. Ann Rheum Dis. 67(12):1678-82, 2008
                                          21. Bibbo C: Wound healing complications and infection following surgery for rheumatoid arthritis. Foot Ankle Clin. 12(3):509-24, vii, 2007
                                          22. Chou LB et al: Treatment of severe, painful pes planovalgus deformity with hindfoot arthrodesis and wedge-shaped tricortical allograft. Foot Ankle Int. 28(5):569-74, 2007
                                          23. Johnson PT et al: CT of the foot: selected inflammatory arthridites. J Comput Assist Tomogr. 31(6):961-9, 2007
                                          24. Molloy AP et al: Surgery of the lesser toes in rheumatoid arthritis: metatarsal head resection. Foot Ankle Clin. 12(3):417-33, vi, 2007
                                          25. Weiss RJ et al: Ankle/hindfoot arthrodesis in rheumatoid arthritis improves kinematics and kinetics of the knee and hip: a prospective gait analysis study. Rheumatology (Oxford). 46(6):1024-8, 2007
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Imaging

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Rheumatoid arthritis (RA)
                                                • Definitions

                                                  • Chronic progressive systemic inflammatory disease in which joints are primary target

                                                IMAGING

                                                • General Features

                                                  • Imaging Recommendations

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Andersson ML et al: Distribution of erosions in hands and feet at the time for the diagnosis of RA and during 8-year follow-up. Clin Rheumatol. 40(5):1799-810, 2021
                                                                                  2. Dakkak YJ et al: Rheumatoid arthritis and tenosynovitis at the metatarsophalangeal joints: an anatomic and mri study of the forefoot tendon sheaths. Radiology. 295(1):146-54, 2020
                                                                                  3. Bruyn GAW et al: Ultrasound of subtalar joint synovitis in patients with rheumatoid arthritis: results of an OMERACT reliability exercise using consensual definitions. J Rheumatol. 46(4):351-9, 2019
                                                                                  4. Harman H et al: Ankle pathologies in patients with inflammatory rheumatic diseases: a clinical and ultrasonographic study. Int J Rheum Dis. 20(6):675-84, 2017
                                                                                  5. Nieuwenhuis WP et al: Evaluation of the diagnostic accuracy of hand and foot MRI for early rheumatoid arthritis. Rheumatology (Oxford). 56(8):1367-77, 2017
                                                                                  6. Toyota Y et al: Musculoskeletal ultrasonography delineates ankle symptoms in rheumatoid arthritis. Mod Rheumatol. 27(3):425-9, 2017
                                                                                  7. Zubler V et al: Frequency of arthritis-like MRI findings in the forefeet of healthy volunteers versus patients with symptomatic rheumatoid arthritis or psoriatic arthritis. AJR Am J Roentgenol. 208(2):W45-53, 2017
                                                                                  8. Naredo E et al: Predictive value of Doppler ultrasound-detected synovitis in relation to failed tapering of biologic therapy in patients with rheumatoid arthritis. Rheumatology (Oxford). 54(8):1408-14, 2015
                                                                                  9. Niki H et al: Long-term outcome of joint-preserving surgery by combination metatarsal osteotomies for shortening for forefoot deformity in patients with rheumatoid arthritis. Mod Rheumatol. 25(5):683-8, 2015
                                                                                  10. Onodera T et al: A comparative study with in vitro ultrasonographic and histologic grading of metatarsal head cartilage in rheumatoid arthritis. Foot Ankle Int. 36(7):774-9, 2015
                                                                                  11. Matsumoto T et al: Radiologic patterning of joint damage to the foot in rheumatoid arthritis. Arthritis Care Res (Hoboken). 66(4):499-507, 2014
                                                                                  12. Stomp W et al: Are rheumatoid arthritis patients discernible from other early arthritis patients using 1.5T extremity magnetic resonance imaging? A large cross-sectional study. J Rheumatol. 41(8):1630-7, 2014
                                                                                  13. Chan PS et al: Natural history and imaging of subtalar and midfoot joint disease in rheumatoid arthritis. Int J Rheum Dis. 16(1):14-8, 2013
                                                                                  14. Bøyesen P et al: Prediction of MRI erosive progression: a comparison of modern imaging modalities in early rheumatoid arthritis patients. Ann Rheum Dis. 70(1):176-9, 2011
                                                                                  15. Aletaha D et al: 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 62(9):2569-81, 2010
                                                                                  16. Narváez JA et al: MR imaging of early rheumatoid arthritis. Radiographics. 30(1):143-63; discussion 163-5, 2010
                                                                                  17. Grondal L et al: The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients. Acta Orthop. 79(2):257-61, 2008
                                                                                  18. Hattori T et al: Radiological study of joint destruction patterns in rheumatoid flatfoot. Clin Rheumatol. 27(6):733-7, 2008
                                                                                  19. Torikai E et al: Comparison between resection arthroplasty alone and resection arthroplasty with arthrodesis of the first MTP joint for rheumatoid forefoot deformities. Mod Rheumatol. 18(5):486-91, 2008
                                                                                  20. Wakefield RJ et al: The optimal assessment of the rheumatoid arthritis hindfoot: a comparative study of clinical examination, ultrasound and high field MRI. Ann Rheum Dis. 67(12):1678-82, 2008
                                                                                  21. Bibbo C: Wound healing complications and infection following surgery for rheumatoid arthritis. Foot Ankle Clin. 12(3):509-24, vii, 2007
                                                                                  22. Chou LB et al: Treatment of severe, painful pes planovalgus deformity with hindfoot arthrodesis and wedge-shaped tricortical allograft. Foot Ankle Int. 28(5):569-74, 2007
                                                                                  23. Johnson PT et al: CT of the foot: selected inflammatory arthridites. J Comput Assist Tomogr. 31(6):961-9, 2007
                                                                                  24. Molloy AP et al: Surgery of the lesser toes in rheumatoid arthritis: metatarsal head resection. Foot Ankle Clin. 12(3):417-33, vi, 2007
                                                                                  25. Weiss RJ et al: Ankle/hindfoot arthrodesis in rheumatoid arthritis improves kinematics and kinetics of the knee and hip: a prospective gait analysis study. Rheumatology (Oxford). 46(6):1024-8, 2007