Rheumatoid Arthritis Clinical Trial
Official title:
Neuropathic Foot and Ankle in Rheumatoid Arthritis : Ultrasound and Nerve Conduction Study
1. To measure the prevalence of Neuropathic pain in Rheumatoid arthritis patients with
ankle and foot pain
2. To evaluate the role of Neuromuscular Ultra sound (NMUS) and nerve conduction study
(NCS) in assessment of Neuropathic foot and ankle in Rheumatoid arthritis patients
Rheumatoid arthritis (RA) is a common chronic systemic autoimmune disease that primarily
affects the lining of the synovial joints which symmetrically involves the small joints, can
cause cartilage and bone damage and associated with progressive disability, premature deaths,
and socioeconomic burdens .
In RA, neuropathic pain "which is defined as pain caused by a lesion or a disease of the
somatosensory system" , could be suggested by :nerve compression, associated comorbidities
and vascuilitis .
Despite the recent advancement in RA treatment, neuropathic pain remains a cause of
persistent pain even in controlled disease activity.
The prevalence of clinical neuropathy varies from 0.5% to 85% in patients with RA, which can
cause functional disability . Foot and ankle pain is highly prevalent in RA with peripheral
neuropathy is a common contributor to it . In previous studies , it was found that the most
foot neuropathies are of tarsal tunnel syndrome, peroneal nerve entrapment and pure sensory
axonal neuropathy.
For evaluation of neuropathic foot and ankle in RA , electrophysiological and imaging
techniques can be very useful.
Nerve conduction study (NCS) is the electrodiagnostic evaluation of the function of
peripheral nerves ,it can provide information regarding the presence, severity and location
of a lesion, symmetricity of neuropathy, mononeuropathy or disorders affecting the
neuromuscular junctions. Also, the functional modality most involved (sensory or motor) and
the predominant pattern of pathology (e.g., axonal, demyelinating, or both.
Neuromascular ultrasond(NMUS) is a new modality of diagnosis developed in the past 20 years ,
and it can assess anatomical abnormalities that can't be evaluated by NCS NMUS being
noninvasive and inexpensive diagnostic modality , it has been introduced as a complement to
NCS for diagnosis of nerve conditions.
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