Tissue Viability and the rheumatoid foot: the importance of an holistic approach to foot ulceration

Rheumatoid arthritis (RA) is an autoimmune systemic disease in which the inflammatory, destructive and erosive nature of the disease process can lead to unpredictable episodes of foot ulceration and therefore prove challenging for practitioners within the multidisciplinary team (MDT). Consequently wound care within this field of clinical practice requires early intervention and identification of predisposing factors to risks of ulceration such as compromised tissue viability, poor tissue perfusion, raised inflammatory markers and foot deformity of which podiatrists and nurses play a pivotal role. This case study explores challenges and highlights the importance of an holistic approach to the management of foot ulceration in a 57-year old patient with a medical history of rheumatoid arthritis who presented with an acute episode of foot ulceration complicated by cellulitis and compromised tissue viability.