Arthritis is a condition that causes joint inflammation, swelling, and pain. The condition occurs when the lubricating cartilage in the joint wears away, leaving irregular cartilage and bone to rub against bone causing pain. Several diseases can result in arthritis, but trauma and rheumatoid disease are the most common causes in the ankle. Rothman doctors specialize in providing care for patients with osteoarthritis and rheumatoid arthritis in Philadelphia.
Osteoarthritis
Osteoarthritis is common at any age but for many occurs when they reach middle age. This arthritis is a “wear and tear” or degenerative type of arthritis. This occurs when the cartilage in the joint wears away and becomes frayed and rough. The protective space between the bones decreases and can cause bone on bone rubbing which will lead to osteophytes (bone spurs) that are painful.
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system turns against itself. Rather than working to protect the joints, the body actually produces substances that cause joint inflammation and destruction. RA is a long-term disorder that causes inflammation of multiple joints and surrounding tissue throughout the body. Of those individuals who suffer from RA, nearly 90 percent develop symptoms at the ankle or foot. In most cases, these symptoms initially appear in the toes and then involve the rear portion of the foot and ankle.
Posttraumatic Arthritis
Previous trauma is the single most common cause of ankle arthritis. Such injuries include previous fractures, joint dislocations, or severe ankle sprains, which can occur years before arthritis begins. These injuries can cause permanent damage to joint cartilage surfaces that help to cushion joints. With time, the damage to cartilage worsens and the joints lose that protective covering. Ultimately, the bones in the joint grind against each other with little or no cartilage left.
Symptoms
- Joint Inflammation
- Swelling
- Pain
- At the ball and side of foot
- With walking
- With motion
- That flares up with activity
- Stiffness
- Deformity
- Walking is affected and can be difficult
- Bunions or Corns may develop as toes develop arthritis
- Arch may start to collapse along the bottom of the foot
- When pressure is applied to joint tenderness is felt
- Joint swelling that is warm or has redness
- When sitting, resting or early morning there is an increase in pain and swelling
Causes
- RA is believed to be caused by a “trigger” and not necessarily an inherited gene. Triggers can be things such as an infection or environmental factor.
- Injury to the foot and or ankle
- Dislocations or Fractures that cause damage to the joint surface
Risk Factors
- Obesity
- Family History
- This condition is common in people over the age of 50, but can start at younger ages.
Diagnosis
What to expect from your doctor’s appointment?
- Check past medical History of you and your family.
- What medications are you on and your overall health
- Exam of the ankle and foot
- Look at your shoewear
- Do a Gait Analysis
- X-rays
- Bone Scan
- CT Scan
- MRI
- Lab Test (to determine what arthritis you may have)
* Depending on the diagnosis your doctor may refer you to a rheumatologist if they suspect rheumatoid arthritis.
Questions you should be prepared to answer
- How long have you had the pain?
- Where is the pain located?
- Is both feet or just the one causing pain?
- Is the pain continuous or come and go?
- Is the pain worse with walking and running?
- Does the pain occur at night or in the morning?
- Was there any prior injuries to the area?
Treatment
Non-Surgical Orthopaedic Care
Surgical
- Arthroscopic debridement
- Arthrodesis (fusion)
- Total Ankle Replacement (arthroplasty)
Prevention
While not all injuries and genetics can be prevented there are a few things that can be done to help prevent or alleviate the symptoms of arthritis.
- Managing a healthy weight
- Exercise Regularly
- Wearing proper shoewear. Getting a gait analysis to determine the correct shoewear for your foot can help with not only foot and ankle pain but can also help to avoid any knee and hip pain.
- Caring for injuries promptly and getting the correct care can help to decrease the chance of arthritis developing.
