{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T17:37:45Z","timestamp":1785605865307,"version":"3.56.0"},"reference-count":45,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Foot problems are highly prevalent in people with rheumatoid arthritis. This study aims to explore the foot morphology, pain and function in rheumatoid arthritis patients and the relation with the time of disease debut. A cross-sectional study was designed. Footprint, the Foot Posture Index, the hallux valgus prevalence, foot pain and function in 66 rheumatoid arthritis patients and the association with time since diagnosis, were recorded. The Foot Function Index, the Manchester Foot Pain and Disability Index, the Visual Analogic Scale, and the Manchester Scale for hallux valgus were administered and analyzed in two groups, with less and more than 10 years of diagnosis of the disease. A high prevalence of pronated (right 36.8% and left 38.6%) and highly pronated (right 15.8% and left 15.8%) feet was observed, as well as an elevated percentage of low arched footprints (right 68.4 and left 66.7%) and hallux valgus (right 59.6% and left 54.4%). Hallux valgus prevalence, toe deformities and Foot Function Index (Functional limitation) factors were significantly associated with the time since RA diagnosed adjusted for the other factors. The adjusted odds ratio of Hallux valgus prevalence was 4.9 (1.2\u201319.7). In addition, the foot function was diminished, and foot pain was present in most participants. In conclusion, rheumatoid arthritis patients\u2019 feet showed altered morphology and function, and with longer rheumatoid arthritis history, metatarsophalangical stability and foot function, but not pain and global foot posture, were likely to deteriorate.<\/jats:p>","DOI":"10.3390\/ijerph18095042","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T10:49:51Z","timestamp":1620643791000},"page":"5042","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Foot Pain and Morphofunctional Foot Disorders in Patients with Rheumatoid Arthritis: A Multicenter Cross-Sectional Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9316-8942","authenticated-orcid":false,"given":"Mar\u00eda","family":"Reina-Bueno","sequence":"first","affiliation":[{"name":"Department of Podiatry, University of Seville, 41004 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5708-4178","authenticated-orcid":false,"given":"Pedro V.","family":"Munuera-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, 41004 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7765-8204","authenticated-orcid":false,"given":"Sergio","family":"P\u00e9rez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of A Coru\u00f1a, 15001 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8217-7664","authenticated-orcid":false,"given":"Mar\u00eda del Carmen","family":"V\u00e1zquez-Bautista","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, 41004 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8549-7703","authenticated-orcid":false,"given":"Gabriel","family":"Dom\u00ednguez-Maldonado","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, 41004 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-8937","authenticated-orcid":false,"given":"Inmaculada C.","family":"Palomo-Toucedo","sequence":"additional","affiliation":[{"name":"Department of Podiatry, University of Seville, 41004 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.3109\/03009742.2015.1110198","article-title":"Effectiveness of insole use in rheumatoid feet: A randomized controlled trial","volume":"45","author":"Moreira","year":"2016","journal-title":"Scand. J. Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1080\/09638280802239441","article-title":"Influence of foot orthoses on plantar pressures, foot pain and walking ability of rheumatoid arthritis patients\u2014A randomised controlled study","volume":"31","author":"Novak","year":"2009","journal-title":"Disabil. Rehabil."},{"key":"ref_3","first-page":"310","article-title":"Effect of rocker shoes on pain, disability and activity limitation in patients with rheumatoid arthritis","volume":"38","author":"Ghasemi","year":"2013","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_4","first-page":"15","article-title":"Evidencia cientifica del tratamiento ortopodologico en pie afectado por artritis reumatoide","volume":"12","year":"2018","journal-title":"Rev. Int. Cienc. Podol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1007\/s00296-010-1700-2","article-title":"Comparison of foot pain and foot care among rheumatoid arthritis patients taking and not taking anti-TNFalpha therapy: An epidemiological study","volume":"31","author":"Otter","year":"2011","journal-title":"Rheumatol. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/14397595.2019.1589921","article-title":"Relationship of callosities of the forefoot with foot deformity, Health Assessment Questionnaire Disability Index, and joint damage score in patients with rheumatoid arthritis","volume":"30","author":"Mochizuki","year":"2020","journal-title":"Mod. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13047-017-0229-y","article-title":"Prevalence, impact and care of foot problems in people with rheumatoid arthritis: Results from a United Kingdom based cross-sectional survey","volume":"10","author":"Wilson","year":"2017","journal-title":"J. Foot Ankle Res."},{"key":"ref_8","first-page":"282","article-title":"Hypermobility of the first ray in ballet dancer","volume":"2","author":"Biz","year":"2012","journal-title":"Muscles Ligaments Tendons J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/BOR.0b013e3283422cf5","article-title":"Arthritis, foot pain and shoe wear: Current musculoskeletal research on feet","volume":"23","author":"Riskowski","year":"2011","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"610","DOI":"10.7547\/8750-7315-104.6.610","article-title":"Effects of Off-the-Shelf Foot Orthoses on Plantar Foot Pressures in Patients with Early Rheumatoid Arthritis","volume":"104","author":"Santos","year":"2014","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/rheumatology\/ket337","article-title":"Kinematic, kinetic and electromyographic response to customized foot orthoses in patients with tibialis posterior tenosynovitis, pes plano valgus and rheumatoid arthritis","volume":"53","author":"Barn","year":"2014","journal-title":"Rheumatology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.foot.2016.03.004","article-title":"Foot orthoses in the management of chronic subtalar and talo crural joint pain in rheumatoid arthritis","volume":"27","author":"Gatt","year":"2016","journal-title":"Foot"},{"key":"ref_13","first-page":"1486","article-title":"HPR the effectiveness of therapeutic footwear in patients with rheumatoid arthritis: A systematic review and meta-analysis","volume":"76","author":"Roorda","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/03009742.2016.1196500","article-title":"Clinical effectiveness and cost-effectiveness of foot orthoses for people with established rheumatoid arthritis: An exploratory clinical trial","volume":"46","author":"Rome","year":"2017","journal-title":"Scand. J. Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.gaitpost.2015.12.039","article-title":"In-shoe plantar pressure measurements for the evaluation and adaptation of foot orthoses in patients with rheumatoid arthritis: A proof of concept study","volume":"45","author":"Dekker","year":"2016","journal-title":"Gait Posture"},{"key":"ref_16","first-page":"1","article-title":"The Effects of off-the-Shelf Foot Orthoses on the Quality of Life of Patients Diagnosed with Early Rheumatoid Arthritis","volume":"3","author":"Santos","year":"2015","journal-title":"Clin. Res. Foot Ankle"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1177\/0269215518819118","article-title":"Effectiveness of custom-made foot orthoses in patients with rheumatoid arthritis: A randomized controlled trial","volume":"33","year":"2019","journal-title":"Clin. Rehabil."},{"key":"ref_18","first-page":"64","article-title":"Efecto de las ortesis plantares hechas a medidas versus placebo en pacientes con artritis reumatoide: Ensayo cl\u00ednico aleatorizado. Estudio piloto","volume":"29","year":"2018","journal-title":"Rev. Espa\u00f1ola Podol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1136\/ard.2010.138461","article-title":"2010 rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"69","author":"Aletaha","year":"2010","journal-title":"Ann. Rheum. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.clinbiomech.2005.08.002","article-title":"Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index","volume":"21","author":"Redmond","year":"2006","journal-title":"Clin. Biomech."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"74","DOI":"10.7547\/87507315-91-2-74","article-title":"The grading of hallux valgus. The Manchester Scale","volume":"91","author":"Garrow","year":"2001","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/0309364612447097","article-title":"Effect of custom-made foot orthoses in female hallux valgus after one-year follow up","volume":"37","author":"Reina","year":"2013","journal-title":"Prosthet Orthot Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/0021-9290(87)90255-7","article-title":"Technical Note the Arch Index: A Useful Measure","volume":"20","author":"Cavanagh","year":"1987","journal-title":"J. Biomech. Biomech."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.foot.2007.06.006","article-title":"Minimal important difference: Values for the Foot Health Status Questionnaire, Foot Function Index and Visual Analogue Scale","volume":"18","author":"Landorf","year":"2008","journal-title":"Foot"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.fas.2013.09.005","article-title":"Cross-cultural adaptation and validation of the Foot Function Index to Spanish","volume":"20","year":"2014","journal-title":"Foot Ankle Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1007\/s11136-013-0507-5","article-title":"Cross-cultural adaptation and validation of the Manchester Foot Pain and Disability Index into Spanish","volume":"23","author":"Ndosi","year":"2014","journal-title":"Qual. Life Res."},{"key":"ref_27","first-page":"48","article-title":"Analysis of Foot Structural Damage in Rheumatoid Arthritis: Clinical Evaluation by Validated Measures and Serological Correlations","volume":"61","author":"Biscontini","year":"2009","journal-title":"Reumatismo"},{"key":"ref_28","first-page":"480","article-title":"To what extent is foot pain related to biomechanical changes and ultrasound-detected abnormalities in rheumatoid arthritis?","volume":"34","author":"Valor","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1757-1146-1-6","article-title":"Normative values for the Foot Posture Index","volume":"1","author":"Redmond","year":"2008","journal-title":"J. Foot Ankle Res."},{"key":"ref_30","first-page":"22","article-title":"Flat foot in a random population and its impact on quality of life and functionality","volume":"11","year":"2017","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1007\/s10067-005-0115-z","article-title":"Foot deformities in rheumatoid arthritis and relevance of foot function index","volume":"25","author":"Bal","year":"2006","journal-title":"Clin. Rheumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/j.1756-185X.2010.01465.x","article-title":"Foot deformities in patients with rheumatoid arthritis: The relationship with foot functions","volume":"13","author":"Adibelli","year":"2010","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_33","first-page":"1","article-title":"The impact of rheumatoid foot on disability in Colombian patients with rheumatoid arthritis","volume":"10","author":"Bayona","year":"2009","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1007\/s00296-017-3699-0","article-title":"Foot health in patients with rheumatoid arthritis\u2014A scoping review","volume":"37","author":"Stolt","year":"2017","journal-title":"Rheumatol. Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1757-1146-3-21","article-title":"Prevalence of hallux valgus in the general population: A systematic review and meta-analysis","volume":"3","author":"Nix","year":"2010","journal-title":"J. Foot Ankle Res."},{"key":"ref_36","unstructured":"Munuera-Mart\u00ednez, P.V. (2012). El Hallux Abductus Valgus. El primer Radio: Biomec\u00e1nica y Ortopodolog\u00eda, Exa Editores."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1007\/s10067-018-4215-y","article-title":"Foot function in rheumatoid arthritis patients: A cross-sectional study","volume":"37","author":"Inoue","year":"2018","journal-title":"Clin. Rheumatol."},{"key":"ref_38","first-page":"4","article-title":"Prevalence of foot problems in people with inflammatory arthritis in Singapore","volume":"9","author":"Carter","year":"2016","journal-title":"J. Foot Ankle Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s10067-015-3124-6","article-title":"Fear of falling and foot pain, impairment and disability in rheumatoid arthritis: A case-control study","volume":"35","author":"Morpeth","year":"2016","journal-title":"Clin. Rheumatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.clinbiomech.2018.04.002","article-title":"Region-specific foot pain and plantar pressure in people with rheumatoid arthritis: A cross-sectional study","volume":"55","author":"Stewart","year":"2018","journal-title":"Clin. Biomech."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.fas.2015.05.014","article-title":"Comparison of dorsal and dorsomedial displacement in evaluation of first ray hypermobility in feet with and without hallux valgus","volume":"22","author":"Singh","year":"2016","journal-title":"Foot Ankle Surg."},{"key":"ref_42","first-page":"40","article-title":"The Disease Activity Score (DAS) and the Disease Activity Score using 28 joint counts (DAS28) in the management of rheumatoid arthritis","volume":"34","author":"Renskers","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1007\/s00132-017-3410-x","article-title":"Konservative Therapie des Hallux-valgus-Syndroms: Was kann man mit Schienen und Einlagen erreichen?","volume":"46","author":"Fuhrmann","year":"2017","journal-title":"Orthopade"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/s00132-017-3415-5","article-title":"Hallux valgus: Konservative und operative Therapie","volume":"46","year":"2017","journal-title":"Orthopade"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s00132-017-3397-3","article-title":"Hallux valgus: \u00c4tiologie, diagnostische und therapeutische Prinzipien","volume":"46","author":"Zirngibl","year":"2017","journal-title":"Orthopade"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/9\/5042\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:58:50Z","timestamp":1760162330000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/9\/5042"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,10]]},"references-count":45,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["ijerph18095042"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18095042","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,10]]}}}