Abstract
OBJECTIVE: To evaluate the prevalence of asymptomatic tarsal tunnel syndrome (TTS) in rheumatoid arthritis (RA) patients and its association with disease activity, inflammation, and electrophysiological changes. METHODS: Forty RA patients and 40 age- and sex-matched controls underwent nerve conduction studies assessing medial plantar, lateral plantar, and posterior tibial nerves. Disease activity (DAS28, RASS), inflammatory markers (ESR, CRP), and autoantibodies (RF, anti-CCP) were recorded. Comparisons used t-tests; correlations assessed associations. RESULTS: RA patients showed significantly prolonged sensory latencies and reduced amplitudes and nerve conduction velocities, especially in medial and lateral plantar nerves. Sensory latencies had 100% sensitivity for subclinical TTS; motor parameters demonstrated high specificity. Higher DAS28, longer disease duration, elevated ESR/CRP, joint deformities, and seropositivity predicted TTS. CONCLUSIONS: Subclinical TTS is highly prevalent in RA and linked to systemic inflammation, disease severity, and structural damage. SIGNIFICANCE: Routine electrophysiological screening may enable early detection and intervention, preserving nerve function and improving long-term mobility and quality of life in RA patients. TRIAL REGISTRATION: The study was approved by the SFHM Institutional Review Board and registered under HAP-02-K-052 in August 2024.