The rheumatoid foot: a sideways look.

As with many other aspects of the foot, the rheumatoid foot, historically, has been treated symptomatically. If there is a painful tenosynovitis, synovectomy; a painful joint not responding to drug treatment, fusion; bony prominences (including metatarsal heads), excision; if the structure collapses, a valgus 'insole'; and if all else fails, bespoke footwear and discharge. But is this good enough for 1990 when our knowledge of orthopaedic biomechanics has developed to a degree unthought of 20 years