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Morton's metatarsalgia in rheumatoid arthritis
Clinical Orthopaedics and Related Research
|July 1, 1979
Summary
This study on Morton's metatarsalgia in rheumatoid arthritis patients found unique characteristics and good surgical outcomes. Early synovectomy proved effective in preventing the condition in rheumatoid arthritis patients.
Area of Science:
- Orthopedics
- Rheumatology
- Pathology
Background:
- Morton's neuroma typically presents differently than in rheumatoid arthritis patients.
- Rheumatoid arthritis can affect the foot, leading to conditions like Morton's metatarsalgia.
Purpose of the Study:
- To investigate the characteristics and outcomes of Morton's metatarsalgia in patients with rheumatoid arthritis.
- To evaluate the effectiveness of early metatarsophalangeal synovectomy as a prophylactic measure.
Main Methods:
- Follow-up study of 66 operations for Morton's metatarsalgia in 52 rheumatoid arthritis patients (1954-1977).
- Histological examination of synovial cavities and nerves.
- Analysis of surgical outcomes and the impact of synovectomy.
Main Results:
- Incidence of Morton's metatarsalgia was 1:520 in rheumatoid patients, with a female-to-male ratio of 9.4:1.
- Histology showed inflammatory/degenerative changes in synovial cavities, often linked to rheumatoid nodules.
- Nerve changes were attributed to chronic compression; surgical removal yielded good results.
- Early metatarsophalangeal synovectomy reduced the need for Morton's metatarsalgia operations from 4.5 to 0.6 per year.
Conclusions:
- Morton's metatarsalgia in rheumatoid arthritis patients has distinct features compared to classic cases.
- Surgical removal of tumor-like formations is effective.
- Early synovectomy is a recommended prophylactic procedure for rheumatoid arthritis patients to prevent Morton's metatarsalgia.