To analyze variable inflammatory manifestations around the foot in the early stages of seronegative spondyloarthropathy.

Sixty patients, who visited the clinic for inflammatory lesions around the foot and were diagnosed with seronegative spondyloarthropathy, were included in this study. The cases were classified according to the main inflammatory lesions of the foot. Extra-skeletal lesions were also evaluated.

Among the main inflammatory lesions of the foot, the most common lesions were insertional Achilles tendinitis and plantar fasciitis in 17 (28.3%) patients. Eleven (18.3%) cases were inflammation of the metatarsophalangeal joint or metatarsal head. Among the cases with multiple foot lesions, both insertional Achilles tendinitis and synovitis of the metatarsophalangeal joint were observed in 8 patients. Among the extra-foot lesions, back pain or synovitis of the knee joint were observed in 17 patients, and 8 cases had sacroilitis. In the patients with extra-skeletal lesions, psoriatic skin lesions were observed in 2 patients and uveitis in 1 patient.

Due to its various and nonspecific manifestations, HLA-B27 related chronic inflammatory foot lesions have been easily overlooked and inappropriately treated. Therefore, particular attention should be paid to HLA-B27 positive cases that have waxing and waning of inflammatory foot lesions.