Rheumatoid Arthritis (RA) is a severely crippling disease which affects the entire body. It is an autoimmune disease, which means the body is fighting the body. This chronic condition produces an immune response from the body against the joints. The more pronounced affects are against the hands and feet. RA is a condition which attacks healthy tissue within the joints, particularly the lining of the joint capsule. This capsule becomes inflamed and destroyed. Over time, the capsule loses its strength. This process allows the toes to migrate towards the outside of the foot.
Women are affected at least 3 times greater than men. The majority of cases affect the smaller joints first. The larger joints (i.e. ankle, knee, elbow) are affected later. This disease also attacks numerous joints at once. Other arthridities, like gout, usually affect one joint at a time. In later stages, nodules may form next to the joints. The most common locations are under the elbow and behind the ear. Other symptoms include stiffness, pain, muscle ache, fever, and anemia. X/Rays are important to evaluate the severity of the deformity.
In later cases, the toes become dislocated in an outward direction. The fat pads of the feet decrease in size. Other examinations may be used to detect the disease. This includes the Latex test, and other blood tests. Rheumatoid factor is usually present in the blood. During the initial stages of the disease, this factor is not always detectable. A sedimentation rate may also be evaluated to determine if the disease process is an active versus chronic stage. Treatment include gold salts, physical therapy, occupational therapy, anti-inflammatory medication, steroids, custom fitted shoes, and repair. Treatment should be a team approach.
