ID | 62298 |
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Author |
Ohashi, Hideki
Department of Orthopaedic Surgery, Takahashi Central Hospital
Nishida, Keiichiro
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Nasu, Yoshihisa
Department of Orthopaedic Surgery, Okayama University Hospital
Saiga, Kenta
Department of Orthopaedic Surgery, Okayama University Hospital
Nakahara, Ryuichi
Department of Orthopaedic Surgery, Okayama University Hospital
Horita, Masahiro
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Okita, Shunji
Department of Orthopaedic Surgery, Okayama City Hospital
Ozaki, Toshifumi
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Abstract | Dorsal dislocation of metatarsophalangeal (MTP) joints of the lesser toe frequently occurs in patients with rheumatoid arthritis (RA), and may cause painful and uncomfortable plantar callosities and ulceration. The current study examined the reliability and clinical relevance of a novel radiographic parameter (the MTP overlap distance [MOD]) in evaluating the severity of MTP joint dislocation. The subjects of the current study were 147 RA patients (276 feet; 1104 toes). MOD, defined as the overlap distance of the metatarsal head and the proximal end of the phalanx, was measured on plain radiographs. The relationship between the MOD and clinical complaints (forefoot pain and/or callosity formation) was analyzed to create a severity grading system. As a result, toes with callosities had a significantly larger MOD. ROC analysis revealed that the MOD had a high AUC for predicting an asymptomatic foot (-0.70) and callosities (0.89). MOD grades were defined as follows: grade 1, 0 <= MOD < 5 mm; grade 2, 5 <= MOD < 10 mm; and grade 3, MOD >= 10 mm. The intra- and inter-observer reliability of the MOD grade had high reproducibility. Furthermore, the MOD and MOD grade improved significantly after joint-preserving surgeries for lesser toe deformities. Our results suggest that MOD and MOD grade might be useful tools for the evaluation of deformities of the lesser toe and the effect of surgical intervention for MTP joints in patients with RA.
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Keywords | lesser toe
metatarsophalangeal joint
rheumatoid arthritis
radiographic measurement
grading system
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Published Date | 2021-07-15
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Publication Title |
International Journal of Environmental Research and Public Health
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Volume | volume18
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Issue | issue14
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Publisher | MDPI
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Start Page | 7520
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ISSN | 1660-4601
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © 2021 by the authors.
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File Version | publisher
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DOI | |
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Related Url | isVersionOf https://doi.org/10.3390/ijerph18147520
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License | https://creativecommons.org/licenses/by/4.0/
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