Hallux Valgus, Flatfoot Linked to Forefoot Callosities in RA

For patients with rheumatoid arthritis (RA), hallux valgus and flatfoot are associated with callosities of the forefoot, according to results published in Modern Rheumatology. The results indicate the need for early diagnosis and foot care for hallux valgus and flatfoot to prevent callosities of the forefoot.

The study included participants with RA (n=202). The researchers examined the prevalence of callosities. They collected clinical data including the Health Assessment Questionnaire Disability Index (HAQ-DI), modified total Sharp score (TSS), hallux valgus angle (HVA), and calcaneal pitch angle (CPA). The researchers compared participants with and without callosities to analyze factors associated with callosities of the forefoot. With 202 participants and 404 feet examined, the prevalence of callosities was 31.2% of all participants and 24.0% of all feet.

The results indicated that participants with callosities of the forefoot had significantly higher TSS of the foot compared with those without callosities (P <.001). Participants with callosities had a significantly worse HAQ-DI walking score compared with those without callosities.

After analyzing cutoff values, the researchers determined that HVA and CPA were significantly associated with callosities of the forefoot, with an odds ratio (OR) of 4.64 with HVA, OR 1.73 with CPA, and OR 2.99 with HVA and CPA combined.

“Patients with RA and callosities of the forefoot have functional disability in walking. Therefore, we recommend early diagnosis for hallux valgus and flatfoot in daily practice,” the researchers wrote.

Reference

Mochizuki T, Yano K, Ikari K, Hiroshima R, Ishibashi M, Okazaki K. Relationship of callosities of the forefoot with foot deformity, health assessment questionnaire disability index, and joint damage score in patients with rheumatoid arthritis [published online March 5, 2019]. Mod Rheumatol. doi: 10.1080/14397595.2019.1589921