A1. Rheumatoid arthritis. A2. Proximal distribution, juxta-articular or generalised osteoporosis, articular erosions, fibular deviation of the digits. A3. As rheumatoid arthritis progresses, the fibular deviation of the digits begins to wreck the forefoot. Dislocation and clawing of the lesser digits along with anterior shift of the plantar fat pad leaves the metatarsal heads prominent and prone to increased callus formation, and even ulceration. The patient may describe the condition as 'walking on marbles'.
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