Multidisciplinary recommendations for diagnosis and treatment of foot problems in people with rheumatoid arthritis

Table 5 Recommendations on check-ups of feet and shoes

	LoE	Ref	LoA
Rheumatologists and nurses specialised in rheumatology should perform regular feet check-ups. These check-ups should include, at least, patient history of foot disease, foot inspection, and palpation of foot joints for the detection of swelling and pain.	4b	n/a	9.2 (8–10)
Over-the-counter shoes should have, at least, sufficient room in the toe box and a stiff sole allowing a heel-to-toe gait. The following additional shoe features may be important, depending on the foot conditions and wishes of the patient: i) light weight; ii) spacious, adjustable, and easy to close in-step/heel girth; iii) strong, raised, and padded heel part; iv) inflection point at the MTP joints; v) adequate length and width, measured in standing position; vi) no seams on the inside; vii) removable insoles so that custom-made foot orthoses can be placed in it.*	3*4a	* [46] ** [32, 33]	9.3 (7–10)

LoE Level of Evidence for the recommendations: (1) research of level A1 or at least 2 independently conducted studies of level A2, (2) 1 study of level A2 or at least 2 independently conducted studies of level B, (3) 1 study of level B or C, (4a) expert opinion described in the literature, (4b) opinion of the expert group. Ref. references. LoA Level of Agreement for the recommendations: Numeric Rating Scale from 0 (total disagreement) to 10 (total agreement) reported as mean (range). n/a not applicable. * refers to the first part of the recommendation with corresponding level of agreement and references. ** refers to the second part of the recommendation with corresponding level of agreement and references

ISSN: 1757-1146