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Often rheumatoid arthritis patients have complications in their feet or ankles that doctors don't discover, for lack of a good way to identify them. UK rheumatologists have published a new instrument (available free online) to resolve this problem.
A new questionnaire designed by rheumatologists in the United Kingdom, published in full in an open-source research journal, should make it easier to detect foot problems that are troubling and disabling patients with rheumatoid arthritis (RA).
Disorders of the foot and ankle have been found in nine of ten patients with RA, two-thirds of whom have more than one such problem. But research shows that these complications receive less attention from doctors than from patients.
Part of the explanation may be that most disability questionnaires for foot problems are not specific to RA. Even instruments designed to assess the foot in musculoskeletal conditions tend to overlook the ankle, which is often affected in RA, according to Rosemary Waller and the team that have created the Swindon Foot and Ankle Questionnaire.
The new instrument consists of ten short questions with quick, binary answers, supplemented by illustrations of the foot intended to help patients identify the location of the problem quickly, even if they aren't good readers. The UK team says that patients should be able to complete the questionnaire in less than one minute, and that scoring it should takenly a few seconds.
In preliminary tests, the questionnaire was mailed to about 600 patients diagnosed with RA. Half returned the completed survey. Echoing earlier findings, over half of these responses included problems with the ankle.
A free full text PDF of the Swindon Foot and Ankle Survey is available online.