Ankle Arthritis

 

Arthritis is a general term used for a group of more than 100 diseases causing pain, inflammation and stiffness around one or more of your joints.  Although it is not as common for arthritis to affect the ankle as much as the other joints, it can seriously affect your mobility and quality of life.

 

With many forms of arthritis, your joints wear down over time, slowly losing the smooth cartilage, causing the bones to rub together.  Soft tissue in your joints may also start to wear down and as a result, may cause the joint not to function the way it should.

 

There is currently no cure for arthritis; however, there are treatment options available to help relieve symptoms and slow the progress of the disease.  With proper treatment, many people with arthritis are able to keep mobility and remain active in order to lead fulfilling lives.

 

Anatomy

When walking, standing, and running, the foot and ankle offer support, shock absorption, balance, and many other functions crucial for full movement.  The ankle joint consists of three bones that mainly assist the ‘up and down’ motion.

 

28 bones in the foot and over 30 joints enable a wide range of movement in the ankle.  The ends of the joints are covered with soft cartilage that allow the bones to glide over each other during movement.  A thin lining known as the synovium, which produces a fluid that lubricates the cartilage and reduces friction, surrounds joints.

 

Tendons and muscles support the joints and provide the strength to make them move while ligaments (bands of tissue) connect the bones and help to keep the joints in place.

 

Forms of Arthritis that Affect the Ankle

It is important to understand the form of arthritis that may be causing your pain as some have specific treatments and medication. Common forms of arthritis found in the ankle include:

 

Osteoarthritis
Osteoarthritis is the most common form of arthritis in people once they reach middle age, but can occur in young people too. Osteoarthritis is a degenerative disease of the joints.  It often occurs due to the typical wear and tear that happens with age.  However, in many cases, ankle osteoarthritis is often linked to a previous ankle injury.  Osteoarthritis causes the cartilage in the joint to gradually wear away and become frayed and rough.  The protection between the bones decreases, resulting in the bones rubbing together, causing pain.  In addition to age, other risk factors that affects osteoarthritis include a family history of the ideas and obesity.

 

Post- Traumatic Arthritis
Post-traumatic arthritis typically occurs following an injury, particularly a bone fracture, sprain or dislocation.  You may not notice the problems for a few years or it can take decades for joint damage from an injury to cause pain.  Similar to osteoarthritis, post-traumatic arthritis causes the cartilage between the joints to wear away.  An injured joint is around seven times more likely than an uninjured joint to become arthritic, even following proper treatment.  In some cases, after an injury, your body may hold hormones that stimulate the death of your cartilage cells.

 

Rheumatoid Arthritis
Rheumatoid arthritis (RA) is one of the most serious forms of arthritis that can affect multiple joints in the body, but is often found first in the foot and ankle.  It is a chronic inflammatory disease where the body’s immune system attacks the joint, usually the same joint on both sides of the body.  The exact cause of RA is unknown.  Even though it is not an inherited disease, there are certain genes found in people that place them at higher risk.  There is typically a trigger such as an infection or environmental factor, which causes the immune system to produce substances that attack the joints. Early signs that you may have RA in the ankle is experiencing difficulty with ramps, inclines and stairs.  As the RA in the ankle advances, standing and basic walking can become painful.

 

Gout
Gout occurs when you have elevated levels of uric acid in the blood from your diet that accumulates and aggravates joints.  For many people, swelling and pain in the big toe is the first symptom of gout.  Gout can affect other joints as well as the big toe, including the ankles.  If you have had gout for years, lumps of uric acid, known as gout trophi, can form underneath the skin around the ankles.

 

Reactive arthritis
This chronic form of arthritis occurs following an infection of the urinary, genital or gastrointestinal systems. The ankles, along with the joints of the feet and knees are often the first joints affected by reactive arthritis.

 

Symptoms of Ankle Arthritis

The symptoms of arthritis vary depending on which joint is affected. In the majority of cases, the joint affected by arthritis will be inflamed and painful.  The pain typically develops over time.  Other symptoms of ankle arthritis include:

 

  • Tenderness when touching or applying pressure to the joint
  • Pain when moving that flares up with vigorous activity
  • Ankle instability
  • Difficulty moving, walking, or weight bearing
  • Joint stiffness, warmth, redness, or swelling
  • Increased pain and swelling in the morning after sleeping, or when resting or sitting still

 

 

Diagnosis of Ankle Arthritis

If a doctor suspects ankle arthritis they will begin by taking a full medical history surrounding your symptoms, including where you feel pain and how it is affecting your daily routine.  They will then examine your ankle to check for signs of arthritis such as swelling and tenderness.

 

Other tests can help assess what forms of arthritis are affecting the ankle and causing pain. Further tests that may be carried out include:

 

X-rays
X-rays can help confirm a diagnosis and determine the extent of the joint damage.

 

MRI
MRI scans can help determine the condition of the bone and soft tissues.

 

Blood Tests
Blood tests can measure inflammation and antibodies to rule out inflammatory arthritis.

 

Gait Analysis
During the physical examination, your doctor will analyse your gait (the way you walk).  If you are limping, this can tell your doctor a lot about the location and severity of your arthritis.  During your gait analysis, your doctor will examine how the bones in your leg and foot line up when you walk, measure your stride and test the strength of your feet and ankles.

 

Your doctor may also examine your shoes to determine whether there is any abnormal or uneven wear and to ensure they are offering sufficient support for your foot and ankle.

 

Treatment of Ankle Arthritis

There is no cure for ankle arthritis.  However, many treatments are available to help relieve pain, improve function and slow down the progression of the disease.

 

Depending on the form of arthritis and symptoms experienced, you may undergo one or more of these treatments:

 

 

In some cases, changes to your daily routine can help relieve the pain and slow the progression of the disease.  These changes include:

 

  • Avoiding activities that aggravate the disease
  • Swapping from high-impact activities (such as jogging or tennis) to lower impact activities (like swimming or cycling)
  • Maintaining a healthy body weight to reduce stress on the joints

 

Outlook

Stiffness, pain and swelling are the main symptoms of arthritis.  The disease can affect any joint but is most commonly found in weight-bearing joints such as the knee, hip, ankle and spine.

 

In most cases, people with arthritis are able to continue to carryout normal, everyday activities.  Exercises, anti-inflammatory drugs and following a healthy lifestyle can all help reduce stiffness, pain and improve function.  In cases of extreme of severe ankle arthritis, orthopaedic surgery can provide pain relief and restore lost joint function.

 

Need Help?

If you are experiencing pain in your foot or ankle and you think it could be ankle arthritis, you can be seen by a Consultant Orthopaedic Foot and Ankle Surgeon at One Ashford Hospital, usually within 48 hours.  One Ashford Hospital is well placed to see patients with knee injuries from Ashford, Maidstone, Canterbury, Folkestone, Dover and all surrounding villages.  To book an appointment, call the hospital direct on 01233 364 022 or email here.