Abstract：
In advanced stages of rheumatoid arthritis (RA), the pattern of joint involvement leads to varied types of foot deformities such as forefoot, midfoot, and hindfoot deformities. We aim to evaluate midfoot and hindfoot deformities and their effect on functional outcomes in RA patients. In this prospective cross-sectional study clinical and radiological evaluations of 100 adult RA patients were studied for midfoot and hindfoot deformities. The RA disease activity, functional disability level, specific foot and ankle assessments, gait speed, and balance tests were assessed. Radiological examinations of the weight-bearing feet in a standing position were done. We found that the most frequent deformity type was the planovalgus foot (24%). There were statistically significant differences between the types of foot deformities and disease duration, disease activity, falls, Tinetti and Berg balance Test, and health assessment questionnaire-disability index. The multivariate regression analysis of independent correlates of falling detected that patients with equinovarus deformity were 2.5 times more liable for falling with 63.5% predictive power. According to the predictive criteria of deformity type for falling, the equinocavovarus type had accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 91%, 84.5%, 98.5%, 99%, and 84%, respectively. We found in RA patients, midfoot and hindfoot deformities cause a significant reduction of functional ability and quality of life. The early detection of foot deformities requires a good awareness of the clinical and radiographic diagnosis of different types of deformities thus reducing the possible functional disabilities via early management by combined orthotic, physiotherapy, and surgical treatments.
摘要：
在类风湿关节炎（RA）的晚期阶段，关节受累的模式导致各种类型的足部畸形，如前足，中足,和后足畸形。我们旨在评估中足和后足畸形及其对RA患者功能预后的影响。在这项前瞻性横断面研究中，对100名成年RA患者的中足和后足畸形进行了临床和放射学评估。RA疾病活动，功能性残疾水平，具体的足部和踝关节评估，步态速度,和平衡测试进行了评估。对站立姿势的负重脚进行了放射学检查。我们发现最常见的畸形类型是扁平足（24％）。足畸形类型和病程差异有统计学意义,疾病活动,falls,Tinetti和Berg平衡测试，健康评估问卷-残疾指数。跌倒的独立相关因素的多元回归分析发现，马蹄畸形患者跌倒的可能性是其2.5倍，预测能力为63.5％。根据跌倒畸形类型的预测标准，equinocavavarus类型具有准确性，灵敏度,特异性，正预测值，阴性预测值为91%，84.5%,98.5%,99%,84%,分别。我们在RA患者中发现，中足和后足畸形会导致功能能力和生活质量的显着降低。足部畸形的早期发现需要对不同类型畸形的临床和影像学诊断有很好的认识，从而通过联合矫形器的早期治疗减少可能的功能残疾。物理治疗,和手术治疗。临床证据水平：4.
