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Viêm khớp dạng thấp của bàn chân và mắt cá chân có thể là một vấn đề suy nhược, đặc biệt đối với những bệnh nhân đã trải qua thành công hông hoặc arthroplasty đầu gối. Quản lý y tế tối ưu, sử dụng dụng cụ chỉnh hình và can thiệp phẫu thuật là những thành phần thiết yếu của chăm sóc bệnh nhân. | Rheumatoid Arthritis of the Foot and Ankle Richard V. Abdo MD and Louis J. Iorio MD Abstract Rheumatoid arthritis of the foot and ankle can be a debilitating problem particularly for patients who have undergone successful hip or knee arthroplasty. Optimal medical management use of orthotic devices and surgical intervention are essential components of patient care. Forefoot involvement with hallux valgus and lesser metatarsophalangeal joint subluxation and dislocation are the most common findings. Reconstruction usually requires lesser metatarsophalangeal joint excisional arthroplasty and first metatarsophalangeal joint arthrodesis. Midfoot tarsometatarsal and intertarsal involvement is treated with orthotic devices and intertarsal fusion for advanced arthropathy. Hindfoot involvement frequently leads to pes planovalgus deformity which may require isolated talonavicular arthrodesis if treated early or triple arthrodesis for advanced destruction. Ankle involvement is less frequent when it is unresponsive to conservative measures ankle symptoms may be improved by arthrodesis. Although great advances have been made in medical and surgical management of rheumatoid arthritis the disease remains a serious problem. Through prudent use of medical management orthotic devices and other conservative measures as well as surgical intervention long-term function can be enhanced greatly. J Am Acad Orthop Surg 1994 2 326-332 Rheumatoid arthritis is a chronic unrelenting progressive condition that affects the musculoskeletal system and also has generalized systemic manifestations. The articular changes include synovitis ligamentous and capsular laxity cartilage destruction and osseous erosion. The extra-articular abnormalities are primarily the result of vasculitis and include rheumatoid nodules digital ischemia skin ulceration pleuritis pericarditis neuropathy lymphadenopathy and splenomegaly. The pathogenesis of rheumatoid arthritis is believed to be mediated through the immune .
