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Department of Podiatry

Rheumatoid Arthritis

The manifestations of RA are diverse. The joints of the foot may be the first involved in this disease. The early radiological findings are mainly of a decreased density in the ends of long bones, effusion within the joint capsule and destruction of the metatarsal heads appears early. Later as the the process continues there is narrowing of joint spaces, generalised demineralisation, subluxations, dislocations, ankylosis and deformity. The deformities which are most obvious are HAV deformities (often progressing to Stage 4), lateral subluxations of the phalanges, increased mobility of the MTPJ's early, followed by decreased mobility later as reparative processes cause calcification of strucures.

Above: Demineralisation evident. Lateral subluxation of phalanges evident.

A radiograph of a hand affected by Rheumatoid arthritis. Note the 'swan neck' deformity of the digits, and the the considerable subluxation of the carpal bones.

The above four radiographs show a foot affected by RA, but also after some extensive (and not particularly successful) surgery. Note although there has been a pan-metatarsal head resection and first metatarsophalangeal joint has been operated upon, there is significant lateral deviation of all the toes.

Content Approved by: Head of Podiatry

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Last Updated: July 8th, 2003