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The Foot and Systemic Lupus Erythematosus

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  #1  
Old 26th July 2013, 08:40 PM
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Default The Foot and Systemic Lupus Erythematosus

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‘Focus on feet’ – the effects of systemic lupus erythematosus: a narrative review of the literature
AE Williams, G Crofts, LS Teh
Lupus July 22, 2013
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Background The manifestations of systemic lupus erythematosus (SLE) vary between individuals, from the severe and life-threatening renal and central nervous system involvement, to the involvement of skin, musculoskeletal and vascular system, and the complications of infection influencing the quality of life. However, as specific manifestations affecting the lower limb are perceived as receiving little focus, the purpose of this narrative literature review is to identify the specific factors associated with SLE that may have implications for lower limb and foot morbidity.

Method A structured search of databases was conducted. The inclusion was restricted to publications in the English language, those that specifically investigate the feet as affected with SLE. No restriction on year of publication was imposed to reduce publication bias and to capture as many publication in relation to feet.

Results Eleven papers fulfilled the inclusion criteria. There were seven additional papers that made observations related to the articular or vascular complications of the feet. This narrative review provides some information on how SLE affects the lower limb and foot in relation to the musculoskeletal and vascular systems. However, there is a lack of literature that specifically focuses on all the manifestations of SLE and the complications associated with its management.

Discussion There are indications that SLE affects lower limb and foot morbidity but the scale of these problems is unclear and this is partly because of the absence of research and the lack of a ‘gold standard’ framework for the assessment of the lower limb and foot. In addition to clinical foot health assessment, ultrasonography may be a useful alternative to plain film radiography or magnetic resonance imaging (MRI) in capturing the extent of articular and extra-articular manifestations. Further, the Ankle Brachial Pressure Index (ABPI) may be useful in identifying those with atherosclerosis and ischaemia.

Conclusion There are indications that SLE affects lower limb and foot morbidity but the scale of these problems and effective management of them is unclear. Therefore, further research is warranted in order to better understand the impact of SLE on the foot and lower limb and its impact on quality of life.
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Old 27th July 2013, 07:04 PM
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Default Re: The Foot and Systemic Lupus Erythematosus

Related Threads:
Other threads tagged with rheumatology
Unmet need for podiatry in rheumatology
Foot health needs in systemic sclerosis
Foot problems in juvenile idiopathic arthritis
Heel pain in spondyloarthropathy
Foot Arthritis in Behçet's disease
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Old 30th July 2013, 01:28 AM
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Default Re: The Foot and Systemic Lupus Erythematosus

Go Anita Williams!!
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Old 16th November 2013, 01:05 PM
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Default Re: The Foot and Systemic Lupus Erythematosus

Ultrasound evaluation of hand, wrist and foot joint synovitis in systemic lupus erythematosus.
Iagnocco A, Ceccarelli F, Rizzo C, Truglia S, Massaro L, Spinelli FR, Vavala C, Valesini G, Conti F.
Rheumatology (Oxford). 2013 Nov 14.
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Objectives. To assess the prevalence and severity of inflammatory abnormalities of the hand, wrist and foot joints in SLE patients by US and to correlate them with clinical, laboratory and disease activity score parameters.

Methods. Sixty-two consecutive SLE patients were enrolled in the present study and underwent clinical evaluation, laboratory tests and bilateral high-resolution US of the hand, wrist and foot joints. Joint effusion (JE), synovial hypertrophy (SH) and local pathological vascularization [power Doppler (PD)] were evaluated according to both a dichotomous score and a semi-quantitative (0-3) grading system. In addition, a global US score was calculated by summing the values given to each elementary lesion for every single joint and every joint group. US findings were correlated with physical examination, serological parameters (CRP, ANA, anti-dsDNA, ENA, aPL, C3 and C4 serum levels) and disease activity indexes (SLEDAI-2K, ECLAM).

Results. US detected inflammatory joint abnormalities in 54/62 patients (87.1%); 72.6% presented involvement of the MTP joints, 46.7% the MCP joints, 19.3% the PIP joints and 53% the wrists. A total of 1984 joints were examined highlighting JE in 19.1% of cases, SH in 6.9% and positive PD in 1.1%. The global US inflammatory score had a mean value of 10.9 (s.d. 15.2). No correlations were found between US findings and SLE disease activity parameters.

Conclusion. US demonstrated a high prevalence of inflammatory joint abnormalities in SLE that were also present in asymptomatic patients. Interestingly, the foot joints were the most frequently involved. US is a valuable tool for detecting subclinical synovitis in SLE.
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Old 14th April 2014, 05:56 AM
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Default Re: The Foot and Systemic Lupus Erythematosus

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Originally Posted by NewsBot View Post
‘Focus on feet’ – the effects of systemic lupus erythematosus: a narrative review of the literature
AE Williams, G Crofts, LS Teh
Lupus July 22, 2013
Does anyone have access to this full article and is willing to share with moi? :)
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Old 21st May 2015, 12:25 PM
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Default Re: The Foot and Systemic Lupus Erythematosus

Toe walking as a presenting sign of systemic lupus erythematosus
M Basiaga, D Sherry
Lupus May 13, 2015
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Toe walking is a previously unreported presentation of systemic lupus erythematosus (SLE). We describe a patient who presented with profound multisystem involvement that was preceded by one month of toe walking and multiple flexion contractures without arthritis. Her lupus is now under control after aggressive therapy, yet she continues to struggle with tendinopathy despite continued physical and occupational therapy. Lupus should be considered in the appropriate clinical context in children who have new-onset contractures due to tight tendons.
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Old 10th June 2015, 08:25 PM
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Default Re: The Foot and Systemic Lupus Erythematosus

FOOT PROBLEMS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS; UNDER-RECOGNISED AND UNDER-TREATED?
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Conclusions: Foot problems appear to be under-recognised in patients with SLE. Health care professionals need to consider a comprehensive foot care plan as part of the holistic management of people with SLE
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