Oedema of Feet and Ankles in Rheumatoid Arthritis

Abstract

Forty patients with rheumatoid arthritis and oedema have been investigated to find the cause of the oedema. Specimens of oedema fluid from 18 of these have been analysed. The oedema is a low-protein oedema, and the protein level bears no relation to duration and no relation to the protein level of serum. There is no relation to inflammation of the joints of the feet and ankles, and no relation to nutritional, cardiac, or renal disease. Varicose veins and thrombophlebitis are not the cause of the oedema. The natural history of this phenomenon suggests that it is a venous oedema, and this is supported by the appearance of the skin of the feet and ankles, and by the oedema-fluid-protein levels. The explanation given by Hollander is incorrect. Oedema of the feet and ankles should be regarded as a clinical feature of rheumatoid arthritis due to altered venous function. © 1964, British Medical Journal Publishing Group. All rights reserved.