Skip to main content
Top
Published in: Journal of Foot and Ankle Research 1/2016

Open Access 01-12-2016 | Research

Prevalence of foot problems in people with inflammatory arthritis in Singapore

Authors: K. Carter, M. Lahiri, P. P. Cheung, A. Santosa, K. Rome

Published in: Journal of Foot and Ankle Research | Issue 1/2016

Login to get access

Abstract

Background

Foot problems are highly prevalent in people with inflammatory arthritis reported from studies in the UK, Europe and New Zealand, but there is limited evidence from Southeast Asia. The study aim was to evaluate the prevalence of foot problems in people with inflammatory arthritis in Singapore.

Methods

People with inflammatory arthritis were recruited from the rheumatology outpatient clinic of a tertiary hospital in Singapore. Disease and clinical characteristics included age, sex, disease duration, current blood tests and medications. The Leeds Foot Impact Scale was used to evaluate foot impairment/disability and the Modified Health Assessment Questionnaire was used to assess global function.

Results

We recruited 101 people with inflammatory arthritis, of which 50 % were female. The majority of participants were Chinese (70 %). The mean (SD) age was 52 (15) years, and the mean (SD) disease duration was 9.3 (0.3) years. The most commonly reported inflammatory arthritic conditions were rheumatoid arthritis (46), gout (31) and spondyloarthritis (15 %). The mean (SD) of the total Leeds Foot Impact Scale was 17 (13) indicating moderate to severe levels of foot impairment and activity limitation. Over 80 of participants reported foot pain during the course of their condition, and 48 % reported current foot pain. Despite the high prevalence of foot pain, only 21 participants (21 %) had been referred to a podiatrist.

Conclusion

This is the first study to investigate the prevalence of foot problems in people with inflammatory arthritis from Singapore. The majority of the participants reported foot problems, but had not been referred to a podiatry service.
Appendix
Available only for authorised users
Literature
1.
go back to reference Juarez M, Price E, Collins D, Williamson L. Deficiencies in provision of integrated multidisciplinary podiatry care for patients with inflammatory arthritis: a UK district general hospital experience. Foot. 2010;20:71–4.CrossRef Juarez M, Price E, Collins D, Williamson L. Deficiencies in provision of integrated multidisciplinary podiatry care for patients with inflammatory arthritis: a UK district general hospital experience. Foot. 2010;20:71–4.CrossRef
2.
go back to reference Grondal L, Tengstrand B, Nordmark B, Wretenberg P, Stark A. The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients. Acta Orthop. 2008;79:257–61.CrossRefPubMed Grondal L, Tengstrand B, Nordmark B, Wretenberg P, Stark A. The foot: still the most important reason for walking incapacity in rheumatoid arthritis: distribution of symptomatic joints in 1,000 RA patients. Acta Orthop. 2008;79:257–61.CrossRefPubMed
3.
go back to reference Brenton-Rule A, Hendry G, Barr G, Rome K. An evaluation of seasonal variations in footwear worn by adults with inflammatory arthritis: a cross sectional observational study using a web-based survey. J Foot Ankle Res. 2014;7:36.CrossRefPubMedPubMedCentral Brenton-Rule A, Hendry G, Barr G, Rome K. An evaluation of seasonal variations in footwear worn by adults with inflammatory arthritis: a cross sectional observational study using a web-based survey. J Foot Ankle Res. 2014;7:36.CrossRefPubMedPubMedCentral
4.
go back to reference Roddy E, Muller S, Rome K, Chandratre P, Hider S, Richardson J, et al. Foot problems in people with gout in primary care: baseline findings from a prospective cohort study. J Foot Ankle Res. 2015;8:15.CrossRef Roddy E, Muller S, Rome K, Chandratre P, Hider S, Richardson J, et al. Foot problems in people with gout in primary care: baseline findings from a prospective cohort study. J Foot Ankle Res. 2015;8:15.CrossRef
5.
go back to reference Hyslop E, McInnes IB, Woodburn J, Turner DE. Foot problems in psoriatic arthritis: high burden and low care provision. Ann Rheum Dis. 2010;69:928.CrossRefPubMed Hyslop E, McInnes IB, Woodburn J, Turner DE. Foot problems in psoriatic arthritis: high burden and low care provision. Ann Rheum Dis. 2010;69:928.CrossRefPubMed
6.
go back to reference Otter S, Lucas K, Springett K, Moore A, Davies K, Cheek L, et al. Foot pain in rheumatoid arthritis prevalence, risk factors and management: an epidemiological study. Clin Rheumatol. 2010;29:255–71.CrossRefPubMed Otter S, Lucas K, Springett K, Moore A, Davies K, Cheek L, et al. Foot pain in rheumatoid arthritis prevalence, risk factors and management: an epidemiological study. Clin Rheumatol. 2010;29:255–71.CrossRefPubMed
7.
go back to reference Rome K, Gow PJ, Dalbeth N, Chapman JM. Clinical audit of foot problems in patients with rheumatoid arthritis treated at Counties Manukau District Health Board, Auckland, New Zealand. J Foot Ankle Res. 2009;2:16.CrossRefPubMedPubMedCentral Rome K, Gow PJ, Dalbeth N, Chapman JM. Clinical audit of foot problems in patients with rheumatoid arthritis treated at Counties Manukau District Health Board, Auckland, New Zealand. J Foot Ankle Res. 2009;2:16.CrossRefPubMedPubMedCentral
8.
go back to reference Koh ET, Tan JW, Thong BY, Teh CL, Lian TY, Law WG, et al. Major trends in the manifestations and treatment of rheumatoid arthritis in a multiethnic cohort in Singapore. Rheumatol Int. 2012;33:1693–703.CrossRefPubMed Koh ET, Tan JW, Thong BY, Teh CL, Lian TY, Law WG, et al. Major trends in the manifestations and treatment of rheumatoid arthritis in a multiethnic cohort in Singapore. Rheumatol Int. 2012;33:1693–703.CrossRefPubMed
9.
go back to reference Lansdown N, Brenton-Rule A, Carroll M, Rome K. Perceived barriers to the management of foot health in patients with rheumatic conditions. J Foot Ankle Res. 2015;8:14.CrossRef Lansdown N, Brenton-Rule A, Carroll M, Rome K. Perceived barriers to the management of foot health in patients with rheumatic conditions. J Foot Ankle Res. 2015;8:14.CrossRef
10.
go back to reference Turner D, Hyslop E, Barn R, McInnes IB, Steultjens MPM, Woodburn J. Metatarsophalangeal joint pain in psoriatic arthritis: a cross-sectional study. Rheumatology. 2013;53:737–40.CrossRefPubMedPubMedCentral Turner D, Hyslop E, Barn R, McInnes IB, Steultjens MPM, Woodburn J. Metatarsophalangeal joint pain in psoriatic arthritis: a cross-sectional study. Rheumatology. 2013;53:737–40.CrossRefPubMedPubMedCentral
11.
go back to reference Alamanos Y, Voulgari PV, Drosos AA. Incidence and prevalence of rheumatoid arthritis, based on the 1987 American College of Rheumatology criteria: a systematic review. Semin Arthritis Rheum. 2006;36:182–8.CrossRefPubMed Alamanos Y, Voulgari PV, Drosos AA. Incidence and prevalence of rheumatoid arthritis, based on the 1987 American College of Rheumatology criteria: a systematic review. Semin Arthritis Rheum. 2006;36:182–8.CrossRefPubMed
12.
go back to reference Lau E, Symmons D, Bankhead C, MacGregor A, Donnan S, Silman A. Low prevalence of rheumatoid arthritis in the urbanized Chinese of Hong Kong. J Rheumatol. 1993;20:1133–7.PubMed Lau E, Symmons D, Bankhead C, MacGregor A, Donnan S, Silman A. Low prevalence of rheumatoid arthritis in the urbanized Chinese of Hong Kong. J Rheumatol. 1993;20:1133–7.PubMed
13.
go back to reference Xiang YJ, Dai SM. Prevalence of rheumatic diseases and disability in China. Rheumatol Int. 2009;29:481–90.CrossRefPubMed Xiang YJ, Dai SM. Prevalence of rheumatic diseases and disability in China. Rheumatol Int. 2009;29:481–90.CrossRefPubMed
14.
go back to reference Mok CC, Tam LS, Chan TH, Lee GKW, Li EKM, Hong Kong Society of Rheumatology. Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology. Clin Rheumatol. 2011;30:303–12.CrossRefPubMed Mok CC, Tam LS, Chan TH, Lee GKW, Li EKM, Hong Kong Society of Rheumatology. Management of rheumatoid arthritis: consensus recommendations from the Hong Kong Society of Rheumatology. Clin Rheumatol. 2011;30:303–12.CrossRefPubMed
17.
go back to reference Hoe J, Koh DR. Rheumatoid arthritis in Singapore: carpal predominance and lower incidence of erosive changes. Ann Acad Med Singapore. 1992;21:741–6.PubMed Hoe J, Koh DR. Rheumatoid arthritis in Singapore: carpal predominance and lower incidence of erosive changes. Ann Acad Med Singapore. 1992;21:741–6.PubMed
18.
go back to reference Veerapen K, Mangat G, Watt I, Dieppe P. The expression of rheumatoid arthritis in Malaysian and British patients: a comparative study. Br J Rheumatol. 1993;32:541–5.CrossRefPubMed Veerapen K, Mangat G, Watt I, Dieppe P. The expression of rheumatoid arthritis in Malaysian and British patients: a comparative study. Br J Rheumatol. 1993;32:541–5.CrossRefPubMed
19.
go back to reference Rome K, Chapman J, Williams AE, Gow P, Dalbeth N. Podiatry services for patients with arthritis: an unmet need. NZ Med J. 2010;123:91–7. Rome K, Chapman J, Williams AE, Gow P, Dalbeth N. Podiatry services for patients with arthritis: an unmet need. NZ Med J. 2010;123:91–7.
20.
go back to reference Prevoo M, Van’t Hof MA, Kuper HH, Van Leeuwen MA, Van de Putte LBA, Van Riel P. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38:44–8.CrossRefPubMed Prevoo M, Van’t Hof MA, Kuper HH, Van Leeuwen MA, Van de Putte LBA, Van Riel P. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38:44–8.CrossRefPubMed
21.
go back to reference Pincus T, Summey JA, Soraci Jr SA, Wallston KA, Hummon NP. Assessment of patient satisfaction in activities of daily living using a modified Stanford health assessment questionnaire. Arthritis Rheumatol. 1983;26:1346–53.CrossRef Pincus T, Summey JA, Soraci Jr SA, Wallston KA, Hummon NP. Assessment of patient satisfaction in activities of daily living using a modified Stanford health assessment questionnaire. Arthritis Rheumatol. 1983;26:1346–53.CrossRef
22.
go back to reference Anderson J, Sayles H, Curtis J, Wolfe F, Michaud K. Converting modified health assessment questionnaire (HAQ), multidimensional HAQ and HAQII scores into original HAQ scores using models developed with a large cohort of rheumatoid arthritis patients. Arthritis Care Res. 2010;62:1481–8.CrossRef Anderson J, Sayles H, Curtis J, Wolfe F, Michaud K. Converting modified health assessment questionnaire (HAQ), multidimensional HAQ and HAQII scores into original HAQ scores using models developed with a large cohort of rheumatoid arthritis patients. Arthritis Care Res. 2010;62:1481–8.CrossRef
23.
go back to reference Helliwell PS, Allen N, Gilworth G, Redmond A, Slade A, Tennant A, Woodburn J. Development of a foot impact scale for rheumatoid arthritis. Arthritis Rheumatol. 2005;53:418–22.CrossRef Helliwell PS, Allen N, Gilworth G, Redmond A, Slade A, Tennant A, Woodburn J. Development of a foot impact scale for rheumatoid arthritis. Arthritis Rheumatol. 2005;53:418–22.CrossRef
24.
go back to reference Turner D, Woodburn J. Characterising the clinical and biomechanical features of severely deformed feet in rheumatoid arthritis. Gait Posture. 2008;28:574–80.CrossRefPubMed Turner D, Woodburn J. Characterising the clinical and biomechanical features of severely deformed feet in rheumatoid arthritis. Gait Posture. 2008;28:574–80.CrossRefPubMed
26.
go back to reference Platto MJ, O’Connell PG, Hicks JE, Gerber LH. The relationship of pain and deformity of the rheumatoid foot to gait and an index of functional ambulation. J Rheumatol. 1991;18:38–43.PubMed Platto MJ, O’Connell PG, Hicks JE, Gerber LH. The relationship of pain and deformity of the rheumatoid foot to gait and an index of functional ambulation. J Rheumatol. 1991;18:38–43.PubMed
27.
go back to reference Garrow AP, Papageorgiou A, Silman AJ, Thomas E, Jayson MIV, Macfarlane GJ. The grading of Hallux Valgus. J Am Podiatr Med Assoc. 2001;91:74–8.CrossRefPubMed Garrow AP, Papageorgiou A, Silman AJ, Thomas E, Jayson MIV, Macfarlane GJ. The grading of Hallux Valgus. J Am Podiatr Med Assoc. 2001;91:74–8.CrossRefPubMed
29.
go back to reference Helliwell P. Lessons to be learned: review of a multidisciplinary foot clinic in rheumatology. Rheumatology. 2003;42:1426–7.CrossRefPubMed Helliwell P. Lessons to be learned: review of a multidisciplinary foot clinic in rheumatology. Rheumatology. 2003;42:1426–7.CrossRefPubMed
30.
go back to reference Williams AE, Bowden AP. Meeting the challenge for foot health in rheumatic diseases. Foot. 2004;14:154–8.CrossRef Williams AE, Bowden AP. Meeting the challenge for foot health in rheumatic diseases. Foot. 2004;14:154–8.CrossRef
31.
go back to reference Rome K, Erikson K, Ng A, Gow PJ, Sahid H, Williams AE. A new podiatry service for patients with arthritis. NZ Med J. 2013;126:70–7. Rome K, Erikson K, Ng A, Gow PJ, Sahid H, Williams AE. A new podiatry service for patients with arthritis. NZ Med J. 2013;126:70–7.
32.
go back to reference Matricali G, Bonen A, Verduyckt J, Taelman V, Verschueren P, Sileghem A, et al. The presence of forefoot problems and the role of surgery in patients with rheumatoid arthritis. Ann Rheum Dis. 2006;65:1254–5.CrossRefPubMedPubMedCentral Matricali G, Bonen A, Verduyckt J, Taelman V, Verschueren P, Sileghem A, et al. The presence of forefoot problems and the role of surgery in patients with rheumatoid arthritis. Ann Rheum Dis. 2006;65:1254–5.CrossRefPubMedPubMedCentral
33.
go back to reference Shi K, Tomita T, Hayashida K, Owaki H, Ochi T. Foot deformities in rheumatoid arthritis and relevance of disease severity. J Rheumatol. 2000;27:8–9. Shi K, Tomita T, Hayashida K, Owaki H, Ochi T. Foot deformities in rheumatoid arthritis and relevance of disease severity. J Rheumatol. 2000;27:8–9.
34.
go back to reference Borman P, Ayhan F, Tuncay F, Sahin M. Foot problems in a group of patients with rheumatoid arthritis: an unmet need for foot care. Open Rheumatol J. 2012;6:290.CrossRefPubMedPubMedCentral Borman P, Ayhan F, Tuncay F, Sahin M. Foot problems in a group of patients with rheumatoid arthritis: an unmet need for foot care. Open Rheumatol J. 2012;6:290.CrossRefPubMedPubMedCentral
35.
go back to reference Rome K, Frecklington M, McNair P, Gow P, Dalbeth N. Foot pain, impairment, and disability in patients with acute gout flares: a prospective observational study. Arthritis Care Res. 2012;1(64):384–8.CrossRef Rome K, Frecklington M, McNair P, Gow P, Dalbeth N. Foot pain, impairment, and disability in patients with acute gout flares: a prospective observational study. Arthritis Care Res. 2012;1(64):384–8.CrossRef
36.
go back to reference Kelli A. Racial and ethnic disparities in osteoarthritis phenotypes. Curr Opin Rheumatol. 2010;22:528–32.CrossRef Kelli A. Racial and ethnic disparities in osteoarthritis phenotypes. Curr Opin Rheumatol. 2010;22:528–32.CrossRef
37.
go back to reference Bakker MF, Jacobs JW, Kruize AA, van der Veen MJ, van Booma-Frankfort C, Vreugdenhil SA, et al. Misclassification of disease activity when assessing individual patients with early rheumatoid arthritis using disease activity indices that do not include joints of feet. Ann Rheum Dis. 2012;71:830–5.CrossRefPubMed Bakker MF, Jacobs JW, Kruize AA, van der Veen MJ, van Booma-Frankfort C, Vreugdenhil SA, et al. Misclassification of disease activity when assessing individual patients with early rheumatoid arthritis using disease activity indices that do not include joints of feet. Ann Rheum Dis. 2012;71:830–5.CrossRefPubMed
38.
go back to reference Woodburn J, Hennessy K, Steultjens M, McInnes, Turner D. Looking through the ‘window of opportunity’: is there a new paradigm of podiatry care on the horizon in early rheumatoid arthritis? J Foot Ankle Res. 2010;3:8.CrossRefPubMedPubMedCentral Woodburn J, Hennessy K, Steultjens M, McInnes, Turner D. Looking through the ‘window of opportunity’: is there a new paradigm of podiatry care on the horizon in early rheumatoid arthritis? J Foot Ankle Res. 2010;3:8.CrossRefPubMedPubMedCentral
39.
go back to reference Gossec L, Pavy S, Pham T, Constantin A, Poiraudeau S, Combe B, et al. Non-pharmacological treatments in early rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion. Joint Bone Spine. 2006;73:396–402.CrossRefPubMed Gossec L, Pavy S, Pham T, Constantin A, Poiraudeau S, Combe B, et al. Non-pharmacological treatments in early rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion. Joint Bone Spine. 2006;73:396–402.CrossRefPubMed
41.
go back to reference Scottish Intercollegiate Guideline Network. Management of early rheumatoid arthritis. A National Clinical Guideline. Edinburgh: Royal College of Physicians of Edinburgh; 2000. Scottish Intercollegiate Guideline Network. Management of early rheumatoid arthritis. A National Clinical Guideline. Edinburgh: Royal College of Physicians of Edinburgh; 2000.
42.
go back to reference Vliet Vlieland TP, Pattison D. Non-drug therapies in early rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2009;23:103–16.CrossRefPubMed Vliet Vlieland TP, Pattison D. Non-drug therapies in early rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2009;23:103–16.CrossRefPubMed
43.
go back to reference Hendry G, Gibson K, Pile K, Taylor L, Du Toit V, Burns J, Rome K. “They just scraped off the calluses”: a mixed methods exploration of foot care access and provision for people with rheumatoid arthritis in south-western Sydney, Australia. J Foot Ankle Res. 2013;6:34.CrossRefPubMedPubMedCentral Hendry G, Gibson K, Pile K, Taylor L, Du Toit V, Burns J, Rome K. “They just scraped off the calluses”: a mixed methods exploration of foot care access and provision for people with rheumatoid arthritis in south-western Sydney, Australia. J Foot Ankle Res. 2013;6:34.CrossRefPubMedPubMedCentral
44.
go back to reference van der Leeden M, Steultjens MP, Terwee CB, Rosenbaum D, Turner D, Woodburn J, Dekker J. A systematic review of instruments measuring foot function, foot pain, and foot-related disability in patients with rheumatoid arthritis. Arthritis Care Res. 2008;59:1257–69.CrossRef van der Leeden M, Steultjens MP, Terwee CB, Rosenbaum D, Turner D, Woodburn J, Dekker J. A systematic review of instruments measuring foot function, foot pain, and foot-related disability in patients with rheumatoid arthritis. Arthritis Care Res. 2008;59:1257–69.CrossRef
45.
go back to reference Naal FD, Impellizzeri FM, Huber M, Rippstein PF. Cross-cultural adaptation and validation of the foot function index for use in German-speaking patients with foot complaints. Foot Ankle Int. 2008;29:1222–8.CrossRefPubMed Naal FD, Impellizzeri FM, Huber M, Rippstein PF. Cross-cultural adaptation and validation of the foot function index for use in German-speaking patients with foot complaints. Foot Ankle Int. 2008;29:1222–8.CrossRefPubMed
46.
go back to reference Kuyvenhoven MM, Gorter KJ, Zuithoff P, Budiman-Mak E, Conrad KJ, Post MW. The foot function index with verbal rating scales (FFI-5 pt): a clinimetric evaluation and comparison with the original FFI. J Rheumatol. 2002;29:1023–8.PubMed Kuyvenhoven MM, Gorter KJ, Zuithoff P, Budiman-Mak E, Conrad KJ, Post MW. The foot function index with verbal rating scales (FFI-5 pt): a clinimetric evaluation and comparison with the original FFI. J Rheumatol. 2002;29:1023–8.PubMed
47.
go back to reference Wu SH, Liang HW, Hou WH. Reliability and validity of the Taiwan Chinese version of the foot function index. J Formos Med Assoc. 2008;107:111–8.CrossRefPubMed Wu SH, Liang HW, Hou WH. Reliability and validity of the Taiwan Chinese version of the foot function index. J Formos Med Assoc. 2008;107:111–8.CrossRefPubMed
48.
go back to reference Woodburn J, Turner DE, Rosenbaum D, Balint G, Korda J, Ormos G, et al. Adaptation and cross cultural validation of the foot impact scale for rheumatoid arthritis using Rasch analysis. Arthritis Care Res. 2012;64:986–92. Woodburn J, Turner DE, Rosenbaum D, Balint G, Korda J, Ormos G, et al. Adaptation and cross cultural validation of the foot impact scale for rheumatoid arthritis using Rasch analysis. Arthritis Care Res. 2012;64:986–92.
Metadata
Title
Prevalence of foot problems in people with inflammatory arthritis in Singapore
Authors
K. Carter
M. Lahiri
P. P. Cheung
A. Santosa
K. Rome
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2016
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/s13047-016-0169-y

Other articles of this Issue 1/2016

Journal of Foot and Ankle Research 1/2016 Go to the issue