The Elusive but Painful Subtalar Joint in Rheumatoid Arthritis
Bibliographic record
Abstract
Foot pain is common in rheumatoid arthritis (RA), from forefoot involvement in early RA to later involvement of the hind foot. Foot and ankle involvement can lead to reduced walking distance and affect quality of life1. The prevalence of hind foot pain was estimated at 17% in early RA and up to 52% in patients with established RA2. Left untreated, inflammation of the subtalar joint can lead to progressive eversion of the joint, posterior tibial tendon tendinopathy, and collapse of the medial arch3. Clinically, pain from the joint is often reported in the lateral hind foot. Anatomically, the talus forms the mechanical gateway from the leg to the foot4. Its superior surface articulates with the fibula and tibia. A complex articulation is formed between the talus, calcaneus, and navicular bone inferiorly and anteriorly4,5. The subtalar joint is functionally a single joint that, anatomically, is divided into an anterior part, the talocalcaneonavicular joint or anterior subtalar joint (ASTJ) and a posterior part, the talocalcaneal joint or posterior subtalar joint (PSTJ)4,5. The ASTJ is formed by the navicular bone and the head of the talus anteriorly and the anterior and middle facets of the talus and the calcaneus (sustentaculum tali) inferiorly (Figure 1a and 1b). The spring ligament supports the joint inferiorly. The talonavicular joint and anterior talocalcaneal joint therefore form a continuity and together will be referred to as the ASTJ4,5. The ASTJ is separated from the PSTJ by the sinus tarsi and tarsal canal with several strong ligaments within the sinus tarsi. The PSTJ consists of the posterior facets of the talus and the calcaneus4,5. It is … Address correspondence to Dr. G.S. Kaeley, 653-1 West Eighth St., LRC 2nd Floor L-14, Jacksonville, Florida 32209-6561, USA. E-mail: drgurj{at}gmail.com
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".