Ultrasound detection of plantar bursitis of the forefoot in patients with early rheumatoid arthritis

Abstract

Objective: To study the plantar forefoot of patients with early rheumatoid arthritis (RA) by ultrasound to detect bursitis and to correlate sonographic findings with symptoms and clinical observations.

Methods: Clinical examination, dorsoplantar radiographs, and transverse sonographic scans of the plantar region of the forefoot were performed on 30 healthy persons as well as 25 patients with early RA and forefoot symptoms.

Results: In 8 patients the examiner could clinically suspect plantar bursitis. Ultrasound revealed 22 incidents of plantar bursitis in 14 of the 25 patients. Except for bursitis in the forefoot no inflammatory findings were detected by ultrasound in 6 patients.

Conclusion: Not only metatarsophalangeal arthritis or flexor tenosynovitis but also plantar bursitis can promote symptoms of the forefoot. Ultrasound is a more objective procedure than clinical examination in diagnosing plantar bursitis. This finding has diagnostic and therapeutic implications.