Intermetatarsal Bursitis in Patients With Rheumatoid Arthritis

Rigshospitalet, Denmark3 enrolled

Overview

The aim of the study is to investigate the incidence and clinical implications of intermetatarsal bursitis (IMB) in patients with rheumatoid arthritis (RA). The hypothesis is that IMB is a cause of pain in patients with RA.

Within the recent years more research have focused on IMB in patients with rheumatologic disorders. There is emerging evidence that IMB is an inflammatory alteration in line with synovitis in patients with RA, and presence of IMB have been linked to the early stages of RA, especially due to the focus of the published literature. The clinical implications of the presence of IMB for the patients are yet to be understood. Limited studies have linked the occurrence of IMB to foot impairment, but no studies have been conducted investigating the direct association between forefoot pain and the presence/absence of IMB.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

DIAGNOSTIC

Masking

SINGLE

Enrollment

Conditions

Intermetatarsal Bursitis Rheumatoid Arthritis

Interventions

Magnetic resonance imagingDIAGNOSTIC_TEST

MRI scan with contrast of the foot or feet

UltrasoundDIAGNOSTIC_TEST

Ultrasound scan of the feet

Corticosteroid injectionDRUG

Administered ultrasound guided to patients with intermetatarsal bursitis

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 18 years * Forefoot pain and diagnosed with RA (patient group) * Diagnosed with an axial arthritis (control group) Exclusion Criteria: * Age \<18 years * Open wounds or ongoing infection in the forefoot at the time of examination * Persons with a history of significant trauma in the forefoot, e.g. any fracture or previous surgeries in the forefoot * Persons who have previously received intermetatarsal treatment (Morton's neuroma or IMB) in the same foot, e.g. injection within 6 months or operation at any time * Exclusion from MRI scan only: * Persons with contraindications to participate in MRI scan * Persons with severely impaired renal function (GFR \<30 ml/min)

Locations (1)

Rigshospitalet Glostrup

Glostrup Municipality, Denmark

Outcomes

Primary Outcomes

Incidence of intermetatarsal bursitis on MRI

High intensity on T2 weighted images, low signal on T1. Thin peripheral enhancement on T1 contrast enhanced pictures.

Time frame: 8 weeks

Incidence of intermetatarsal bursitis on US

Hypoechoic mass between metatarsal heads. Activity on power/color doppler.

Time frame: 8 weeks

Incidence of other pathology on MRI

Other than intermetatarsal bursitis

Time frame: 8 weeks

Incidence of other pathology on US

Other than intermetatarsal bursitis

Time frame: 8 weeks

Change in Visual Analogue Score (VAS) score

Pain score related to the foot pain

Time frame: At inclusion, 1 and 3 month(s) post treatment

Secondary Outcomes

Incidence of opening toes

Presence of opening toes/V-sign/spreading toes.

Time frame: 1 day

Data from ClinicalTrials.gov

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