A pilot investigation of the prevalence of US‐detectable forefoot joint pathology and reported foot‐related disability in participants with systemic lupus erythematosus

• Published in: Journal of foot and ankle research 2016-08, Vol.9 (1), p.27-n/a
• Main Authors: Mukherjee, Sandeep, Cherry, Lindsey, Zarroug, Jalaa, Culliford, David, Bowen, Catherine, Arden, Nigel, Edwards, Christopher
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Bursa; Bursa (Anatomy); Bursa, Synovial - diagnostic imaging; Disability Evaluation; Distribution; Female; Foot Diseases - diagnostic imaging; Foot Diseases - etiology; Forefoot; Forefoot, Human - diagnostic imaging; Human; Humans; Joint diseases; Joints; Lupus erythematosus; Lupus Erythematosus, Systemic - complications; Male; Metacarpophalangeal Joint - diagnostic imaging; Metatarsophalangeal Joint - diagnostic imaging; Middle Aged; Physiological aspects; Pilot Projects; Prevalence; Severity of Illness Index; Synovial; Synovitis - diagnostic imaging; Synovitis - etiology; Systemic; Systemic lupus erythematosus; Ultrasonography; Ultrasonography, Doppler - methods
• ISSN: 1757-1146; 1757-1146
• DOI: 10.1186/s13047-016-0158-1

Background The main aim of this study was to determine the prevalence of US‐detectable forefoot bursae, metatarsophalangeal (MTP) joint and metacarpophalangeal (MCP) joint synovial hypertrophy (SH), Power Doppler (PD) signal or erosion in participants with systemic lupus erythematosus (SLE). A secondary aim was to determine the strength of potential association between patient reported foot‐related disability and US‐detected forefoot bursae, MTP joint SH, PD signal or erosion in participants with SLE. Method A cross‐sectional observational study of 20 participants with SLE was completed to determine the prevalence of US‐detected forefoot bursal, MTP and MCP joint pathology. Patient‐reported foot‐related impairment and activity limitation (accumulatively referred to as disability) were also recorded. Spearmans' Rank Correlation analyses were completed to determine the potential strength of association between US‐detected pathology and patient report disability. Results The prevalence of MTP joint SH and PD was 80 % (16/20) and 10 % (2/20), respectively. The prevalence of MCP joint SH and PD was 60 % (12/20) and 30 % (6/20) respectively. A significant association was noted between PD scores for the MTP joints and MCP joints (r = 0.556; p = 0.011) although this was not demonstrated for SH scores (r = 0.176; p = 0.459). Significant associations between forefoot bursal prevalence and MTP joint PD were noted (r = 0.467; p = 0.038). The prevalence of bursae and bursal PD (grade 2 or above) was 100 % (20/20) and 10 % (2/20), respectively. Moderate foot‐related impairment and activity limitation was reported by 95 and 85 % of participants respectively. Conclusion This pilot study suggests that US‐detected MTP, MCP joint and forefoot bursal abnormalities may be prevalent in participants with SLE and they may experience a moderate level of foot‐related disability. Further research is required to substantiate these preliminary findings.