Flexor Hallucis Longus tendon rupture in RA-patients is associated with MTP 1 damage and pes planus.
BACKGROUND
To assess the prevalence of and relation between rupture or tenosynovitis of the Flexor Hallucis Longus (FHL) tendon and range of motion, deformities and joint damage of the forefoot in RA patients with foot complaints.


METHODS
Thirty RA patients with painful feet were analysed, their feet were examined clinically for the presence of pes planus and range of motion (ROM), radiographs were scored looking for the presence of forefoot damage, and ultrasound examination was performed, examining the presence of tenosyovitis or rupture of the FHL at the level of the medial malleolus. The correlation between the presence or absence of the FHL and ROM, forefoot damage and pes planus was calculated.


RESULTS
In 11/60(18%) of the feet, a rupture of the FHL was found. This was associated with a limited motion of the MTP1-joint, measured on the JAM (chi2 = 10.4, p = 0.034), a higher prevalence of pes planus (chi2 = 5.77, p = 0.016) and a higher prevalence of erosions proximal at the MTP-1 joint (chi2 = 12.3, p = 0.016), and joint space narrowing of the MTP1 joint (chi2 = 12.7, p = 0.013).


CONCLUSIONS
Rupture of the flexor hallucis longus tendon in RA-patients is associated with limited range of hallux motion, more erosions and joint space narrowing of the MTP-1-joint, as well as with pes planus.
Baan
Henriette
H
Ziekenhuis Groep Twente, Almelo & Hengelo, The Netherlands. h.baan@a1.nl
Drossaers-Bakkers
Wiepke K
WK
Dubbeldam
Rosemary
R
Buurke
Jaap J
JJ
Nene
Anand
A
van de Laar
Martin A F J
MA
D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D015897:Comorbidity; D005413:Flatfoot / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D018409:Foot Injuries / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D013710:Tendons / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014034:Toes / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014463:Ultrasonography