Abstract
Objective To assess the prevalence of foot IF in RMD patients with foot pain.
Methods In a retrospective design, 1,752 MRIs of consecutive patients presenting with foot pain in two time periods between 2016 - 2018 were evaluated. The group with IF was matched with controls with foot pain without IF. Bone mineral density (BMD) was assessed by DXA. Multivariate analyses were performed.
Results A total of 1,145 MRIs of patients (mean age 59 years, 83% female) with inflammatory (65.4%) or non-inflammatory RMD (34.6%) was available. Most patients had RA (42.6%), psoriatic arthritis (22.4%), axial spondyloarthritis (11.1%) or connective tissue disease (7.6%). Foot IF were found in 129 MRI of patients (7.5%). There was no difference between time periods. The prevalence of IF was highest in CTD (23%) and RA (11.4%). More patients with an inflammatory than a noninflammatory RMD had IF: 9.1% vs 4.1%, respectively (p<0.001). Using CR, IF were only detected in 25%. Low BMD and a history of fractures were more frequent in patients with IF: 42.6% vs 16.2% and 34.9% vs 8.6%, respectively (p<0.001).
Conclusion A high prevalence of foot fractures was found in MRI of RMD patients, many without osteoporosis. MRI was more sensitive than X-rays to detect IF.