Foot and Ankle Arthritis Proper Diagnosis Key To Treatment

By Steven K. Neufeld, MD

While there are over 100 types of arthritis, the one that most commonly affects the foot and ankle is osteoarthritis (“osteo” means bone). Osteoarthritis develops as a result of aging and is known as “wear and tear” arthritis. As we age the thin covering (cartilage) on the ends of our bones can become worn and frayed. This results in inflammation, swelling, and pain in the joint.

An injury to a joint, even if treated properly, can cause osteoarthritis to develop in the future. This is often referred to as traumatic arthritis. It may develop months or years after a severe sprain, torn ligament or broken bone.

Anatomy

There are 28 bones and over 30 joints in the foot. Tough bands of tissue, called ligaments, hold the bones and joints in place. If arthritis develops in one or more of these joints, your balance and walk may be affected. The foot joints most commonly affected by arthritis include the

Ankle, where the shinbone rests on the uppermost bone of the foot

Three joints of the hindfoot

Midfoot, where one of the forefoot bones (metatarsals) connects to the smaller midfoot bones

Great toe, where the first metatarsal connects to the toe bone (this is also where bunions usually develop)

Signs and symptoms of arthritis of the foot vary, depending on which joint is affected. Common symptoms include pain or tenderness, stiffness or reduced motion, and swelling. Walking may be difficult.

Diagnosing Arthritis Of the Foot and Ankle

Your doctor will begin by getting your medical history, doing a physical exam, and may do a gait analysis. This shows how the bones in your leg and foot line up as you walk. It also measures your stride and tests the strength of your ankles and feet.

You may also need some diagnostic tests. X-rays can show changes in the spacing between bones or in the shape of the bones themselves. A bone scan, computed tomography (CT) scan, or magnetic resonance image (MRI) may also be helpful.

Treating Your arthritis

Depending on the type, location and severity of your arthritis, there are many types of treatment available. Nonsurgical treatment options include

Taking pain relievers and anti-inflammatory medication to reduce swelling

Putting a pad, arch support or other type of insert in your shoe

Wearing a custom-made shoe, such as a stiff-soled shoe with a rocker bottom

Using an ankle-foot orthosis (AFO)

Wearing a brace or using a cane

Participating in a program of physical therapy and exercises

Controlling your weight or taking nutritional supplements

Getting a dose of steroid medication injected into the joint

If your arthritis doesn't respond to such conservative treatments, surgical options are available, and may be necessary depending on your condition. Your first step is to see a board certified foot and ankle surgeon who can assess your options towards restoring pain free mobility.