Abstract
Objective|
To observe on X-ray, the heel in rheumatoid arthritis (RA) and in a control group, and observe the possible relations with flatfoot and other radiological symptoms.
Methods
302 feet (rheumatoid feet, RF) of 151 patients with RA are compared to 200 feet of 100 consecutive patients with simple neck pain (control group, CF). The RF and CF groups are homogeneous in sex, age and laterality of the foot. Lateral weight-bearing radiographs are obtained for each foot. Three ranges of angular variations which correspond to cavus foot, middle foot and flatfoot are observed. Several other radiological features are studied: plantar calcaneal exostosis (pCE), large pCE, posterior exostosis (PCE), large PCE, posterior calcaneitis, plantar calcaneitis and dorsal osteophytosis of the first metatarsal bone.
Results
The incidence of PCE is greater in RF than in CF on the whole (p = 0.005), before 50 years (p = 0.002) and (on the limit) after 50 years (p = 0.059). In RF, PCE is correlated with flatfoot (p = 0.03) and age (p = 0.048), but more significantly with disease duration (p = 0.001). The incidence of PCE increases more significantly with age in CF (p = 0.0005) than in RF. In CF the role of age seems to be more important than the role of flatfoot in the appearance of PCE.
Conclusion
The plantar calcaneal exostosis is more frequent in the rheumatoid foot where it increases with flatfoot and age, and more significantly with disease duration. On the other hand, in control feet, the plantar calcaneal exostosis is more significantly correlated with age.
Résumé
L’enthésophyte sous-calcanéen à l’insertion de l’aponévrose plantaire est plus fréquent dans la polyarthrite rhumatoïde où il augmente en fréquence avec le pied plat, avec l’âge et surtout avec la durée de la maladie. À l’inverse, dans les pieds témoins, cet enthésophyte sous-calcanéen est mieux corrélé avec l’âge.
Article PDF
Similar content being viewed by others
References
Arnett FC, Edworthy SM, Bloch DA, et al (1988) The American Rheumatism Association 1987 revised criteria for rheumatoid arthritis. Arthritis Rheum 31:315–324
Steinbrocker O, Traeger CH, Batterman RC (1949) Therapeutic criteria in rheumatoid arthritis. JAMA 140:659–662
Bouysset M, Tebib J, Weil G, et al (1989) The rheumatoid heel: its relationship to other disorders in the rheumatoid foot. Clin Rheum 8(2):208–214
Bouysset M, Tebib J, Noel E, et al (2002) Rheumatoid flatfoot and deformity of the first ray. J Rheumatol 29:903–905
Resnick D (1976) Roentgen features of the rheumatoid mid and hindfoot. J Can Ass Radiol 27:99–107
Bywaters EGL (1953) Hell lesions of rheumatoid arthritis. Ann Rheum Dis 13:42–50
Gerster JC, Wichert L, Bennami A, Fallet GH (1977) The painful heel. Ann Rheum Dis 36:343–348
Bassiouni M (1965) Incidence of calcaneal spurs in osteoarthrosis and rheumatoid arthritis and in control patients. Ann Rheum Dis 24:490–493
Bouysset M, Coury F, Bonnin M, et al (2010) Le pied creux est-il affecté par l’affaissement de la voûte plantaire dans la polyarthrite rhumatoïde ? Med Chir Pied 26:75–80
Hicks JH (1954) The mechanics of the foot: the plantar aponeurosis and the arch. J Anat 88:25–31
Hedrick MR (1996) A current topic review: the plantar aponeurosis. Foot Ankle Int 17:646–649
Fiolkowski P, Brunt D, Bishop M, et al (2003) Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg 42:327–333
Taunton JE, Ryan MB, Clement DB et al (2002) Plantar fasciitis: a retrospective analysis of 267 cases. Physical Therapy in Sport 3(2):57–65
Viel E, Esnault M (1989) The effect of increased tension in the plantar fascia: a biomechanical analysis. Physiother Theory Pract 5:69–73
Walther M, Radke S, Kirschner S, et al (2004) Power Doppler findings in plantar fasciitis. Ultrasound Med Biol 30:435–440
Berkowitz JF, Rudicel S (1991) Plantar fasciitis: MR imaging. Radiology 179:665–667
Pfeffer GB, Bacchetti P, Deland J, et al (1999) The non-operative treatment of proximal plantar fasciitis. Foot Ankle Int 20:214–221
Schepsis AA, Leach RE, Gorzyca J (1991) Plantar Fasciitis. Etiology, Treatment, Surgical Results and review of the literature. Clin Orthop Relat Res 266:185–196
Leach RE, Seavey MS, Salter DK (1986) Results of surgery in athletes with plantar fasciitis. Foot Ankle 7:156–161
Snider MP, Clancy WG, BcBeath AA (1983) Plantar fascia release for chronic plantar fasciitis in runners. Am J Sports Med 11:215–219
Shama SS, Kominsky SJ, Lemont H (1983) Prevalence of painful heel spur and its relation to postural foot position. J Am Podiatry Assoc 73:122–123
Prichasuk S, Subhadrabandhu T (1994) The relationship of pes planus and calcaneal spur to plantar heel pain. Clin Orthop 306:192–196
Holmes GB, Mann RA (1992) Possible epidemiological factors associated with rupture of posterior tibial tendon. Foot Ankle 13:70–79
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Bouysset, M., Coury, F., Damiano, J. et al. Calcaneal involvement in rheumatoid arthritis and in a control group (X-ray study). Med Chir Pied 27, 52–56 (2011). https://doi.org/10.1007/s10243-011-0309-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10243-011-0309-9