Rheumatoid Arthritis: Hindfoot Disease
Rheumatoid arthritis frequently involves the hindfoot. It may produce a proliferative synovial hypertrophy around the tendons and a gradual destruction of the joints. Unfortunately, this part of the foot frequently is overlooked when caring for these patients who often have multiple areas of involvement giving pain and producing a deformity. Treatment consists of nonoperative measures such as proper footwear, physical modalities, and occasional injections of corticosteroids. It is important to preserve the function of the posterior tibial tendon and not allow the hindfoot to develop a valgus deformity. Arthrodesis of selected hindfoot joints provides relief of pain and prevents or corrects hindfoot deformity. It is critical to evaluate simultaneously the ankle joint in all these patients.