Clinical signs in the foot for ligamentous laxity

NewsBot · Aug 4, 2015

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Clinical signs in the foot that are predictors of ligamentous laxity in the adult population
Salom?n Benham?-Benham?a, Gabriel Dom?nguez-Maldonadoa, Raquel Garc?a-De-La-Pe?aa, Mar?a Dolores Jim?nez-Cristinob, Gabriel Gijon-Nogueronc, ,
Journal of Tissue Viability; 29 July 2015

Highlights
?The Beighton score is used as a diagnosis method of ligamentous laxity. The foot isn't included in it.
?4 clinical signs (factors) present in the foot which allow the detection of ligamentous laxity.
?2 evaluations on footprints and 2 exploratory manoeuvres were used.
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Objectives

This study evaluates the influence of ligamentous laxity on the foot from observation of clinical signs and quantification of certain joint ranges.

Methods

The sample consisted of 400 subjects ? 200 in the non-lax control group (ages 32.49 ? 11.06 years) and 200 in the lax group (ages 29.82 ? 9.41 years). The Beighton criteria were applied to each subject to diagnose laxity or non-laxity after noting their gender, age, and 2 joint ranges and 2 clinical signs for both feet. This was an observational analytical study of cases and controls, in which a multivariate binary logistic regression model was applied.

Results

Extension of the first metatarsophalangeal joint (MTPJ) ≥95?, extension of the 1st toe's interphalangeal joint (IPJ) ≥14?, and the signs 1st ?in the plantar footprint, marked and narrowly confined support under metatarsal heads? and 2nd ?in the plantar footprint, continuity of the 1st toe to the 1st metatarsal? presented significant differences between the lax and the non-lax groups. These are usable as parameters with which to detect laxity. The Beighton criteria were confirmed as being the most appropriate for diagnosis.

Conclusions

We propose the use of 2 clinical signs that can be evaluated in plantar footprints (?1st? and ?2nd?) and 2 exploratory manoeuvres (extension of the first MTPJ ≥95? and extension of the 1st toe's IPJ ≥14?) as factors present in the foot which allow the detection of ligamentous laxity in the adult population, for subsequent confirmation by applying the Beighton criteria.
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NewsBot · Jun 30, 2018

Relationship of Joint Hypermobility with Ankle and Foot Radiographic Osteoarthritis and Symptoms in a Community-Based Cohort.
Golightly YM et al
Arthritis Care Res (Hoboken). 2018 Jun 28. doi: 10.1002/acr.23686

OBJECTIVE:
To explore associations of joint hypermobility (a condition where range of motion is greater than normal) with ankle and foot radiographic osteoarthritis and symptoms in a large community-based cohort of African American and Caucasian adults 55-94 years old.

METHODS:
Ankle and foot radiographs and joint hypermobility data (Beighton Criteria) were available for 848 participants (2003-2010) in this cross-sectional study. General joint hypermobility was defined as a Beighton score ≥4 (range 0-9); knee hypermobility was defined as hyperextension of at least one knee. Standing anteroposterior and lateral foot radiographs were read with standard atlases for Kellgren-Lawrence grade, osteophytes and joint space narrowing at the tibiotalar joint and for osteophytes and joint space narrowing to define osteoarthritis at five foot joints. Ankle or foot symptoms were self-reported. Separate person-based logistic regression models were used to estimate associations of ankle and foot osteoarthritis and symptom outcomes with hypermobility measures, adjusting for age, sex, race, body mass index, and history of ankle/foot injury.

RESULTS:
This sample was: 68% women and 33% African American; mean age=71 years; mean body mass index=31 kg/m2 ; general joint hypermobility=7%, knee hypermobility=4%; ankle injury=11.5%, foot injury=3.8%. Although general joint hypermobility was not associated with ankle and foot outcomes, knee hypermobility was associated with ankle symptoms, foot symptoms, and talonavicular osteoarthritis (adjusted odds ratios of 4.4, 2.4, and 3.0, respectively).

CONCLUSIONS:
Knee joint hypermobility may be related to talonavicular osteoarthritis and to ankle and foot symptoms
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