Anatomical location of erosions at the metatarsophalangeal joints in patients with rheumatoid arthritis
Open Access
- 29 January 2014
- journal article
- research article
- Published by Oxford University Press (OUP) in Rheumatology
- Vol. 53 (5), 932-936
- https://doi.org/10.1093/rheumatology/ket478
Abstract
Objective. The aim of this study was to identify the anatomical location of erosions at the MTP joints in patients with RA using high-resolution 3T MRI. Methods. In 24 patients with RA, the more symptomatic forefoot was imaged using 3T MRI. T1-weighted, intermediate-weighted and T2-weighted fat-suppressed sequences were acquired through the MTP joints, together with three-dimensional volumetric interpolated breath-hold examination (3D VIBE) and T1-weighted fat-suppressed post-gadolinium contrast sequences. Images were scored for bone erosion in the distal and proximal part of the MTP joints using the RA MRI scoring (RAMRIS) system. The base of the proximal phalanx and the head of the metatarsal were divided into quadrants to determine the location of erosions (octants) in the dorsal-medial, dorsal-lateral, plantar-medial and plantar-lateral regions. Results. Seventeen females and seven males with a mean age of 55.5 years and disease duration of 10.6 years (range 0.6–36) were included. Eighteen patients were RF positive, the mean 44-joint DAS for CRP and ESR (DAS44CRP and DAS44ESR) were 2.5 (s.d. 0.8) and 2.6 (s.d. 0.9), respectively. In this cohort of patients with RA, irrespective of MTP joint location, octants located in the proximal part (metatarsal) of the joint and the plantar aspect of the joint were more eroded. Conclusion. This is the first study to report the anatomical location of erosions at the MTP joints in patients with RA. We noted that erosions were more commonly seen on the plantar aspect of the metatarsal head in RA, supporting the hypothesis of a relationship between biomechanical demands and bone changes in the forefoot.This publication has 20 references indexed in Scilit:
- Characterising the clinical and biomechanical features of severely deformed feet in rheumatoid arthritisGait & Posture, 2008
- Prevalence and course of forefoot impairments and walking disability in the first eight years of rheumatoid arthritisArthritis Care & Research, 2008
- Assessment of foot impairment in rheumatoid arthritis patients by dynamic pedobarographyGait & Posture, 2008
- The foot: still the most important reason for walking incapacity in rheumatoid arthritis: Distribution of symptomatic joints in 1,000 RA patientsActa Orthopaedica, 2008
- Forefoot joint damage, pain and disability in rheumatoid arthritis patients with foot complaints: the role of plantar pressure and gait characteristicsRheumatology, 2005
- Debridement of plantar callosities in rheumatoid arthritis: a randomized controlled trialRheumatology, 2004
- Pedobarography and its relation to radiologic erosion scores in rheumatoid arthritisRheumatology International, 2004
- Role of metacarpophalangeal joint anatomic factors in the distribution of synovitis and bone erosion in early rheumatoid arthritisArthritis & Rheumatism, 2003
- The course of radiologic damage during the first six years of rheumatoid arthritisArthritis & Rheumatism, 2000
- Radiographic Evaluation of Rheumatoid Arthritis and Related Conditions by Standard Reference FilmsActa Radiologica. Diagnosis, 1977