Decreased foot-related quality of life is a risk factor for falls in patients with rheumatoid arthritis.

Objectives: To assess the need to treat forefoot lesions in rheumatoid arthritis (RA) patients who are unaware of their foot problems.

Methods: From April to September 2022, 116 RA patients at our clinic were administered the Self-Administered Foot Evaluation Questionnaire (SAFE-Q), a self-assessment questionnaire on foot-related issues, and underwent forefoot radiography. We also assessed the occurrence of falls one year later. Among the 88 patients who were unaware of foot problems, we analysed the frequency and type of forefoot deformities and conducted a multivariate analysis to identify factors predicting falls during the 12-month follow-up.

Results: Of the unaware patients, 64 (72.7%) had forefoot deformities and 17 (19.3%) experienced falls within the first year. The fall group had a history of falls and lower SAFE-Q scores but did not significantly differ from others in terms of forefoot deformities. Multivariate analysis identified a history of falls and lower SAFE-Q scores as predictive factors for future falls.

Conclusions: Decreased foot-related quality of life is a risk factor for falls, even in patients who are unaware of their foot problems. Physicians should regularly assess foot-related quality of life using tools such as SAFE-Q to help prevent falls in RA patients.