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PubMed · 11312379

Foot problems in patients with systemic sclerosis.

H Sari-Kouzel·C E Hutchinson·A Middleton·F Webb·T Moore·K Griffin·A L Herrick
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Abstract

OBJECTIVES: To assess the nature of the foot problems experienced in patients with systemic sclerosis (SSc) and patient awareness of such problems. METHODS: Fifty unselected patients (42 females, eight males) with SSc were assessed by means of examination by a senior podiatrist, completion of a questionnaire detailing past and present foot problems, determination of random plasma glucose, plain X-rays of the feet, and measurement of the ankle/brachial index and of digital pulses by Doppler ultrasound. RESULTS: Eighty-six per cent of patients reported colour changes in their feet in response to temperature changes, 82% reported pain usually related to cold, 26% had suffered foot ulceration and 8% had a history of foot surgery. Podiatry assessment confirmed the presence of significant abnormalities, including ulcerations in 10%, pre-ulcerative lesions in 34%, toenail changes in 62%, callus formation in 80% and calcinosis in 18%. Forty per cent of the patients had problems with the fitting of shoes, and 19% had been provided with footwear from the hospital. Plain films of the feet demonstrated the presence of erosions in 6%, soft-tissue calcification in 17%, osteopenia in 26% and degenerative changes in 60% of cases. Ten per cent of the patients had an abnormal ankle brachial index (less than 1.0). Only 21% of the 47 patients in whom digital pulses were examined had normal pulses in all toes, and in 26% all toe pulses were absent. CONCLUSION: Although problems with the hands are well recognized in SSc, foot problems also occur in the majority of patients, and can be a cause of major disability. Care of the feet is therefore an important part of the management of SSC.

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AdultAgedAnkleCross-Sectional StudiesFemaleFoot DiseasesHumansMaleMiddle AgedScleroderma, SystemicJournal Article

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H Sari-Kouzel, C E Hutchinson, A Middleton, F Webb, T Moore, K Griffin, A L Herrick. 2001. Foot problems in patients with systemic sclerosis.. https://doi.org/10.1093/rheumatology%2F40.4.410

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