Relations between flexor hallucis longus changes and pes planus in patients with rheumatoid arthritis / 中华骨科杂志

ABSTRACT

Objective To assess the correlation between tenosynovitis or rupture of the flexor hallucis longus (FHL) and pes planus in patients with rheumatoid arthritis (RA).Methods The data of 47 RA patients (97 feet) with painful feet was retrospectively analyzed which was collected From February 2008 to June 2011.In accordance with the results of the FHL changes got by ultrasonography,the patients were divided into 3 groups.Group A consisted of those with normal FHL (27 feet).Group B consisted of those with FHL tenosynovitis (40 feet),and Group C eonsisted of those with FHL rupture (27 feet).Load bearing lateral radiographs were taken for all the patients.The correlation study was carried out based on the pes planus-related parameters,such as the measurement of heel pitch angle (HPA) and tarsal and 1st metatarsal angle (TM1).Factors like patients' age and course of disease were also taken into the consideration during the study.Results The mean age of those in group A was 49.9±9.2 years vs.56.2±9.2 years in group B and 54.7±8.0 years in group C.The mean duration was 4.7±2.6 years in Group A vs.16.2±7.4 years in Group B 5°±3.6° in Group C.The mean TM1 was 2.5°±2.2° in Group A vs.6.5°±3.2° in Group B and 11.2°±4.9° in Group C.Significant statistics difference were found among the three groups in these parameters.HPA＜ 20° was found among 6/27 feet in group A,31/40 in group B and 27/27 in group C.TM1 ＞4° was found among 5/27 feet in group A,30/40 in group B and 27/27 in group C.Conclusion FHL changes were common in RA patients and its severitv had positive correlation to pes planus.These changes were affected by age and duration,and could be evaluated effectively by ultrasound.