J Korean Orthop Assoc.
2006 Oct;41(5):850-856.
Manifestations of Foot Inflammation in Seronegative Spondyloarthropathy
- Affiliations
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- 1Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea. hosng@amc.seoul.kr
Abstract
- PURPOSE
To analyze variable inflammatory manifestations around the foot in the early stages of seronegative spondyloarthropathy.
MATERIALS AND METHODS
Sixty patients, who visited the clinic for inflammatory lesions around the foot and were diagnosed with seronegative spondyloarthropathy, were included in this study. The cases were classified according to the main inflammatory lesions of the foot. Extra-skeletal lesions were also evaluated.
RESULTS
Among the main inflammatory lesions of the foot, the most common lesions were insertional Achilles tendinitis and plantar fasciitis in 17 (28.3%) patients. Eleven (18.3%) cases were inflammation of the metatarsophalangeal joint or metatarsal head. Among the cases with multiple foot lesions, both insertional Achilles tendinitis and synovitis of the metatarsophalangeal joint were observed in 8 patients. Among the extra-foot lesions, back pain or synovitis of the knee joint were observed in 17 patients, and 8 cases had sacroilitis. In the patients with extra-skeletal lesions, psoriatic skin lesions were observed in 2 patients and uveitis in 1 patient.
CONCLUSION
Due to its various and nonspecific manifestations, HLA-B27 related chronic inflammatory foot lesions have been easily overlooked and inappropriately treated. Therefore, particular attention should be paid to HLA-B27 positive cases that have waxing and waning of inflammatory foot lesions.