Objectives. Despite increased awareness of the high prevalence and significance of foot and ankle problems in rheumatoid arthritis (RA), feet remain neglected. Reasons may include the perception that feet are difficult to assess, they are not included in the DAS28, and lack of freely available foot screening tools specific for RA. Methods. The Swindon Foot and Ankle Questionnaire (SFAQ) is a simply worded 10-point foot and ankle screening questionnaire with diagrams of feet and ankles for use in general rheumatology outpatients. All RA patients on our electronic database were invited to complete the questionnaire and attend clinic for assessment. Patients assessed clinically were scored out of 10 using the parameters from the questionnaire. The SFAQ was compared to the Manchester Foot Pain and Disability Index (MFPDI), DAS28, HAQ, HAD, and OSRA scores. Results. 597 questionnaires were sent, 301 (50%) returned, and 137 seen in clinic. There was good correlation between the postal SFAQ score, clinic score ( ), and the MFPDI ( ). Neither of the foot scores correlated with other RA disease outcome measures. 75% patients completed the picture. 73% corresponded to clinical findings. 45% of patients required an intervention following clinical review and trended towards higher scores. Conclusions. The SFAQ was quick to complete and correlated with the MFPDI. Lack of association with standard RA outcome measures suggests that relying on these scores alone may miss foot pathology. The diagrams were a useful complement. This simple screening tool could aid identification of RA foot and ankle problems. 1. Introduction Foot and ankle problems affect 90% of rheumatoid arthritis (RA) patients [1, 2] and can be important factors in reducing quality of life, disability, and depression [3–8]. Recent national guidelines emphasise the importance of podiatric assessment both at the time of diagnosis and as part of ongoing routine care [9–12]. Despite this feet remain a neglected area. Contributory factors include the perception that foot assessment is complicated and time consuming, with medical staff having varying experience and confidence, and patients’ difficulty in accurately describing foot and ankle problems [13]. The widespread use of the DAS28 score, which does not include the feet and ankles, means that clinically important problems may be missed. A recent survey of our patient population to establish the prevalence of foot problems highlighted the need for a rapid screening tool for use in clinic to yield useful practical information to determine which patients
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