Rheumatoid Arthritis In The Foot And Ankle
Rheumatoid Arthritis (RA) is an autoimmune disease affecting multiple joints throughout the body and can cause debilitating pain. More than 90% of those who suffer from RA will experience foot and ankle pain at some point. The cause of RA is not entirely known – it is believed that it may be genetic, or can be triggered by environmental factors.
As an autoimmune disease RA causes the body to attack its own tissue causing synovium, a joint lubricant, to swell and become inflamed. When this happens it weakens ligaments which can result in bone deformities such as hammer toe and claw toe. While foot and ankle pain are the first symptoms in 20% of afflicted patients, the disease also affects nerves, blood vessels and tendons.
Symptoms & Diagnosis
Pain, swelling and stiffness are the most common symptoms of RA. Difficulty navigating stairs and inclines typically indicate ankle pain that may be caused by rheumatoid arthritis. Doctors can examine skin to check for calluses which indicate areas of abnormal pressure. He or she will also check the foot’s shape to determine if there is any noticeable deformity. Arthritis which has progressed will limit flexibility and increase joint stiffness as cartilage is depleted. Unusual tenderness may also be present.
If physical tests are inconclusive imaging tests may be performed to look at the foot’s structure. These generally include X-rays, computerized tornography (CT) scans and magnetic resonance imaging (MRI).
Treatment
Sadly, there is no cure for RA. Non-surgical treatments are generally rest and ice, combined with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen. Orthotics and braces may be prescribed to reduce pressure on specific areas of the foot. A doctor may prescribe steroidal cortisone injections in the early stages of the disease to slow its progression.
In advanced cases, surgery may be the only option. Surgical procedures include joint fusion with titanium hardware and in extreme scenarios, total joint replacement. Consult a doctor if you suspect you may be experiencing rheumatoid arthritis.
Sources
Rheumatoid arthritis of the foot and ankle. (2011, December). Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00163
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