Strictly-speaking, the word arthritis means inflammation of joint! However, in common parlance, the word is used to describe any condition affecting a joint. It is a general term, as there are a number of different types of arthritis.
Examples of these include:
This is a degenerative disorder affecting the bearing surface or articular cartilage of the joint. The cartilage gradually softens, splits and falls apart, until the underlying bone is exposed. This results in varying degrees of pain, stiffness and swelling. It can be primary, when it has an inherited underlying cause, or secondary, when it has a specific identifiable cause.
Primary osteoarthritis (OA) runs in families and usually affects multiple joints. In the foot, it has a predilection for the midfoot and the joint at the base of the big toe (1st MTP joint).
Secondary OA can be post-traumatic, when a joint has been damaged by a fracture or joint surface injury. It can also result from abnormal forces on a joint over a long period of time, such as when the bones around a weight-bearing joint are malaligned or when adjacent joints have been stiffened or fused.
Rheumatoid and psoriatic arthritis are examples of inflammatory joint disease where synovitis, inflammation of the lining membrane of a joint, damages the joint surfaces, as well as the surrounding bone and supportive soft tissues, causing often prodigious swelling, pain, stiffness and deformity. The inflammatory process can also attack the membrane surrounding tendons, causing them to be damaged and sometimes rupture.
In the foot, rheumatoid arthritis most commonly attacks the joints of the forefoot, leading to severe toe deformities. In the hindfoot, the condition can produce a flatfoot deformity.
Gout is one example of an inherited metabolic disorder, where crystals can be deposited in joint surfaces and the soft tissues around joints, causing them to undergo degenerative and destructive changes. During an acute gout attack, these crystals precipitate into a joint, provoking an intense inflammatory reaction characterised by severe pain, swelling, redness and heat.
In the foot, any joint can be affected, but the one at the base of the big toe is the most common.
Whatever the type or cause of arthritis, management depends on the severity of pain and functional disturbance. Treatment is individualised and is based on many other factors, including a patient’s age, general health, activity level and personal goals
Non-operative measures include anti-inflammatory and simple analgaesic medication, splintage, firm-soled shoes, arch-supported insoles, activity modification, weight-loss and, perhaps, the occasional joint injection of cortisone.
Operative options for foot and ankle arthritis range from joint realignment procedures, the removal of bony prominences (osteophytes) around joints, the fusion (arthrodesis) of joints, to total ankle replacement surgery.
All surgical procedures involve risks. The information provided here is for general educational purposes only. For specific advice regarding arthritis of the foot and ankle, please book an appointment with Dr Newman.