Seronegative arthropathies in the foot

Area of Science:

• Rheumatology
• Immunology
• Orthopedics

Background:

• Foot involvement is a common and varied clinical feature in seronegative arthropathies.
• These manifestations differ from rheumatoid arthritis and can suggest spondarthritis.
• Distinguishing features of spondarthritis in the foot are not pathognomonic and can overlap with other conditions.

Purpose of the Study:

• To delineate the characteristic foot involvement in seronegative arthropathies.
• To compare and contrast foot manifestations across different spondarthritic conditions and rheumatoid arthritis.
• To highlight diagnostic challenges due to overlapping features.

Main Methods:

• Review of clinical presentations of foot involvement in various seronegative arthropathies.
• Comparative analysis of joint, periarticular, and surface manifestations.
• Examination of histological similarities between conditions.

Main Results:

• Osteolysis and periosteal changes in psoriatic arthritis can mimic other conditions.
• Calcaneal enthesitis is common in spondylitis, Reiter's disease, and psoriatic arthritis, but also seen in metabolic arthropathies.
• Psoriatic arthritis and Reiter's disease show similar foot arthritis patterns, including IP joint involvement and hindfoot enthesitis.

Conclusions:

• Foot involvement in seronegative arthropathies, particularly spondarthritis, exhibits significant overlap with other conditions.
• Features like nail dystrophy and keratoderma blenorrhagica can be indistinguishable between psoriatic arthritis and Reiter's disease.
• Understanding these overlaps is crucial for accurate diagnosis and management of seronegative arthropathies.