Ankle Pain: Isolated Symptom or Sign of Arthritis?

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  • Symptoms of Ankle Pain

    Symptoms of Ankle Pain

    Whether ankle pain is caused by arthritis or something else, it can send you to the doctor looking for answers. If you visit your doctor for ankle pain, they’ll examine the ankle joint. This is where the tibia (shinbone) rests on the talus (top foot bone).

    If you’re experiencing arthritis, you may have pain, tenderness, swelling, stiffness, and reduced range of motion. If you have pain, you may feel it mainly in the front of your ankle. This discomfort can make it difficult for you to walk.

    Click through the slideshow to learn more about ankle arthritis and dealing with its symptoms.

  • Types of Ankle Arthritis

    Types of Ankle Arthritis

    People tend to associate arthritis with the knees, hips, and wrists, but it can also occur in the ankles. When arthritis occurs in the ankles, it’s often due to an old injury, such as a dislocation or fracture. Doctors call this “post-traumatic” arthritis.

    Another cause is rheumatoid arthritis (RA), which affects the whole body, including the ankle area. Primary osteoarthritis (OA), wich results from degeneration or “wear-and-tear” over time, rarely occurs in the ankles.

  • Post-Traumatic Arthritis

    Post-Traumatic Arthritis

    Ankle arthritis can be a delayed response to a major sprain, dislocation, or fracture. Your doctor will ask about any history of injury. A big sprain can injure the cartilage and lead to joint instability. This can cause degenerative changes.

    Evidence of damage usually shows up on X-rays within about two years after the injury. But it may be decades until you notice severe pain.

  • Rheumatoid Arthritis

    Rheumatoid Arthritis

    Your doctor may also ask about pain in other joints. Additional discomfort may indicate systemic inflammation, such as RA.

    Your doctor may want to see you standing while barefoot to check your leg alignment. The soles of your shoes may also reveal wear patterns that confirm alignment problems related to RA in your ankles.

  • Looking at Painful Activities

    Looking at Painful Activities

    An interview with your doctor may reveal what activities lead to ankle twinges. If walking uphill hurts, you may have arthritis in the front of your ankle. If the back of the ankle hurts when you walk downhill, the rear of the joint may have problems.

    Discomfort as you walk on uneven ground may suggest an unstable ankle or problems in the subtalar area, which is below the ankle joint. Instability and swelling suggest weakened ligaments.

  • Diagnosis

    Diagnosis

    To diagnose arthritis, your doctor will take your medical history and ask about injuries and previous infections. They also may request X-rays. An X-ray technician will take images of your ankle from multiple angles while you stand. A radiologist will examine your ankle joint alignment and the narrowing in your joint space.

    Your doctor will also examine the way you walk, studying your cadence, speed, and stride length.

  • The Gait Test

    The Gait Test

    Don’t be surprised if your doctor closely watches how you walk into the room. Your overall lower limb alignment will give clues as to how well your hips, knees, and ankles are doing.

    How your foot hits the ground also tells a story. For example, if your ankle motion is restricted, you raise your heel from the floor prematurely and bend your knees in a choppy fashion.

    Your doctor or arthritis specialist will examine the rotation of your foot relative to your lower leg.

  • Your Options

    Your Options

    If you have ankle arthritis, you may need to rest your ankle to minimize the pain. If you enjoy exercise, your doctor may recommend swimming and cycling, in order to protect your ankle.

    The small ankle joint bears five times your body weight on each step, so weight reduction can help. Medications are also common in treating arthritis. Your doctor may recommend aspirin, naproxen, or ibuprofen. For more severe arthritis, they may prescribe you disease-modifying antirheumatic drugs (DMARDs).

References:

  • Amendola, A., & Stone, J. W. (2010). AANA advanced arthroscopy. Philadelphia, Pa.: Saunders/Elsevier.
  • Ankle arthritis. (2013, January 1). UW Medicine Orthopaedics and Sports Medicine. Retrieved December 16, 2013, from http://www.orthop.washington.edu/?q=patient-care/articles/ankle/ankle-arthritis.html
  • Arthritis of the foot and ankle (2008, September 1). American Academy of Orthopaedic Surgeons. Retrieved December 16, 2013, from http://orthoinfo.aaos.org/topic.cfm?topic=a00209
  • Clair, E. W., Pisetsky, D. S., & Haynes, B. F. (2004). Rheumatoid arthritis. Philadelphia, Pa.: Lippincott Williams & Wilkins.
  • DiGiovanni, C. W., & Greisberg, J. (2007). Ankle arthritis. Foot and ankle: core knowledge in orthopaedics (pp. 177-94). Philadelphia, Pa.: Elsevier Mosby.
  • Rheumatoid arthritis of the foot and ankle. (2011, December 1). American Academy of Orthopaedic Surgeons. Retrieved December 16, 2013, from http://orthoinfo.aaos.org/topic.cfm?topic=a00163
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