Abstract
Objective: To establish the prevalence of foot ulceration in patients with rheumatoid arthritis (RA) in secondary care.
Methods: A postal survey of all patients with RA (n = 1,130) under the care of rheumatologists in Bradford, West Yorkshire, UK was performed. The prevalence data were validated through clinical examination, case-note review, and contact with health professionals. The false-negative rate was investigated in a subsample of patients (n = 70) who denied any history of ulceration.
Results: The postal survey achieved a 78% response rate. Following validation, the point prevalence of foot ulceration was 3.39% and the overall prevalence was 9.73%. The false-positive rate was initially high at 21.21%, but use of diagrammatic questionnaire data to exclude leg ulceration reduced the rate to10.76%. The false-negative rate was 11.76%. The most common sites for ulceration were the dorsal aspect of hammer toes, the metatarsal heads, and the metatarsophalangeal joint in patients with hallux abducto valgus, with 33% of patients reporting multiple sites of ulceration. Patients with open-foot and healed-foot ulceration had significantly longer RA disease duration, reported significantly greater use of special footwear, and had a higher prevalence of foot surgery than ulcer-free patients.
Conclusion: Foot ulceration affects a significant proportion of patients with RA. Further work is needed to establish risk factors for foot ulceration in RA and to target foot health provision more effectively.
Original language | English |
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Pages (from-to) | 200-205 |
Number of pages | 6 |
Journal | Arthritis Care and Research |
Volume | 59 |
Issue number | 2 |
Early online date | 31 Jan 2008 |
DOIs | |
Publication status | Published - 15 Feb 2008 |
Keywords
- rheumatoid arthritis (RA)
- foot ulceration
- foot health
ASJC Scopus subject areas
- Rheumatology