Insufficiency Fractures Are a Common Cause of Foot Pain in Inflammatory Rheumatic Diseases

Patients with rheumatoid arthritis (RA) and other chronic inflammatory rheumatic diseases commonly have foot pain. Insufficiency fractures (due to normal stresses on abnormal bone) are a potentially preventable cause of foot pain in these patients, who often have comorbid osteoporosis due to menopause, glucocorticoid use, and decreased mobility. The prevalence of and best diagnostic approach to insufficiency fractures in this population are uncertain.

In a retrospective study, investigators at a tertiary rheumatology center analyzed 1750 MRI scans of the foot or ankle from patients with foot pain but no history of trauma; 65% had an inflammatory rheumatic disease, and the others had mechanical or degenerative conditions or fibromyalgia. The …