Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2014 May;53(5):932-6.
doi: 10.1093/rheumatology/ket478. Epub 2014 Jan 29.

Anatomical location of erosions at the metatarsophalangeal joints in patients with rheumatoid arthritis

Heidi J Siddle  1 , Elizabeth M A Hensor, Richard J Hodgson, Andrew J Grainger, Anthony C Redmond, Richard J Wakefield, Philip S Helliwell
Affiliations
Observational Study

Anatomical location of erosions at the metatarsophalangeal joints in patients with rheumatoid arthritis

Heidi J Siddle et al. Rheumatology (Oxford). 2014 May.

Abstract

Objective: The aim of this study was to identify the anatomical location of erosions at the MTP joints in patients with RA using high-resolution 3T MRI.

Methods: In 24 patients with RA, the more symptomatic forefoot was imaged using 3T MRI. T1-weighted, intermediate-weighted and T2-weighted fat-suppressed sequences were acquired through the MTP joints, together with three-dimensional volumetric interpolated breath-hold examination (3D VIBE) and T1-weighted fat-suppressed post-gadolinium contrast sequences. Images were scored for bone erosion in the distal and proximal part of the MTP joints using the RA MRI scoring (RAMRIS) system. The base of the proximal phalanx and the head of the metatarsal were divided into quadrants to determine the location of erosions (octants) in the dorsal-medial, dorsal-lateral, plantar-medial and plantar-lateral regions.

Results: Seventeen females and seven males with a mean age of 55.5 years and disease duration of 10.6 years (range 0.6-36) were included. Eighteen patients were RF positive, the mean 44-joint DAS for CRP and ESR (DAS44CRP and DAS44ESR) were 2.5 (s.d. 0.8) and 2.6 (s.d. 0.9), respectively. In this cohort of patients with RA, irrespective of MTP joint location, octants located in the proximal part (metatarsal) of the joint and the plantar aspect of the joint were more eroded.

Conclusion: This is the first study to report the anatomical location of erosions at the MTP joints in patients with RA. We noted that erosions were more commonly seen on the plantar aspect of the metatarsal head in RA, supporting the hypothesis of a relationship between biomechanical demands and bone changes in the forefoot.

Keywords: RAMRIS; erosion; magnetic resonance imaging; metatarsophalangeal joint; rheumatoid arthritis.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Grondal L, Tengstrand B, Nordmark B, et al. The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients. Acta Orthop. 2008;79:257–61. - PubMed
    1. Otter SJ, Lucas K, Springett K, et al. Foot pain in rheumatoid arthritis prevalence, risk factors and management: an epidemiological study. Clin Rheumatol. 2010;29:255–71. - PubMed
    1. van der Leeden M, Steultjens MP, Ursum J, et al. Prevalence and course of forefoot impairments and walking disability in the first eight years of rheumatoid arthritis. Arthritis Rheum. 2008;59:1596–602. - PubMed
    1. Hulsmans HM, Jacobs JW, van der Heijde DM, et al. The course of radiologic damage during the first six years of rheumatoid arthritis. Arthritis Rheum. 2000;43:1927–40. - PubMed
    1. Tan AL, Tanner SF, Conaghan PG, et al. Role of metacarpophalangeal joint anatomic factors in the distribution of synovitis and bone erosion in early rheumatoid arthritis. Arthritis Rheum. 2003;48:1214–22. - PubMed

Publication types