ABSTRACT
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterised by synovitis and periarticular bone loss. This chapter aims to provide a guide on how to assess a patient with RA, including commonly encountered anti-arthritic medications, conservative measures and surgical options available. Laboratory investigations that should be performed in patients with suspected RA include erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor and anti-cyclic citrullinated peptide antibodies. Radiographic evaluation should include weight-bearing views of the foot and ankle. Prescription footwear is an important adjunct therapy in RA patients because they have lost the fatty protective plantar tissue, have hypersensitive and inflamed skin and unstable joints. The orthotics function to: redistribute weight-bearing forces, decrease vertical and shear pressure and also horizontal movement within the foot. In the ankle and hindfoot, fluoroscopic guided injections have been shown to be superior to blind injections for diagnostic purposes and temporary relief of synovitis or arthritis.
