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Foot Pathology in Patients with Paget’s Disease of Bone

Anita E. Williams, BSc(Hons) ^* , Terence W. O’Neill, MD , Sylvia Mercer, BSc(Hons) , Brigitte Toro, PhD   and Christopher J. Nester, PhD 

^* Department of Podiatry, University of Salford, Salford, England.
Centre for Rehabilitation and Human Performance Research, University of Salford, Salford, England.
Department of Rheumatology, Hope Hospital, Salford, England.
Department of Physiotherapy, University of Salford, Salford, England.

Corresponding author: Anita E. Williams, BSc(Hons), Directorate of Podiatry, University of Salford, Frederick Rd, Salford, England M6 6PU.

Abstract

The characteristic bone deformities associated with advanced Paget’s disease of bone may result in abnormal gait and plantar foot pressures, which contribute to the development of pressure-related skin problems. This study aimed to characterize the foot problems and foot-care needs in this patient group and to investigate the effect of disease distribution on the occurrence of foot pathology. One hundred thirty-four patients with Paget’s disease were assessed clinically, and the Foot Structure Index was completed for each patient. Patients completed self-administered questionnaires concerning foot function (Foot Function Index) and quality of life (12-Item Short Form). The results of this study suggest that foot-health and footwear problems are common in patients with Paget’s disease. Forty percent of the patients required professional foot care in addition to those already receiving it. The site of pagetic involvement did not affect the occurrence of foot pathology. Further research is required on the impact of the extent of any femoral or tibial deformity on foot symptoms and pathology. Biomechanical studies of the forces and motion in the foot related to different degrees of femoral and tibial deformity might also help determine the impact of deformity on foot pathology. (J Am Podiatr Med Assoc 96(3): 226–231, 2006)