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Arthritis of the Foot and Ankle

When the big toe possesses no motion, it is termed Hallux Rigidus and when the big toe joint may appear to have normal motion, but this motion can be limited when weight is on the foot and during the normal standing and walking, it is termed functional Hallux limitus, because it occurs during the normal functioning of the foot while walking. As with many conditions that affect the foot, functional conditions progress to structural deformities. As the condition progresses, a degenerative type of arthritis develops in the big toe joint.
The most common cause is an abnormal alignment of the long bone behind the big toe joint called the first metatarsal bone. In this condition, the first metatarsal bone is elevated relative to the other metatarsal bones that lie behind the other toes. When this is the case, the big toe joint cannot move smoothly and jamming occurs at the joint. A variety of symptoms can begin to occur. One common problem that occurs is pain in the bottom of the big toe where a central callus can develop. The pain and callus develop because the big toe does not bend upward enough as the bottom of the toe is jammed into the ground. People who have diabetes must watch this area carefully because the pressure can cause the development of an ulceration that can become infected. Another consequence of the jamming of the big toe joint is the development of bone spurs on the top of the joint. This bump on the top of the big toe joint can become painful as a result of shoe pressure. Pain within the joint is a common result of the limitation of movement of the big toe joint. With time, the big toe joint becomes stiff and painful to move. As the joint continues to degenerate more bone spurring occurs. If the condition is left untreated complete destruction of the joint can occur.
Just like the toes, the knee or hip, arthritis can exist also in the ankle. Ankle arthritis usually results from some type of injury in the past, like a fracture or severe sprain. It is rare for arthritis to occur spontaneously in the ankle, unless there is a history of some type of inflammatory arthritis (i.e. rheumatoid arthritis).
Some typical symptoms may include pain and swelling, especially worse with activity or prolonged walking. Some of the ways we treat ankle arthritis are with non-steroidal anti-inflammatory drugs (NSAIDs), various types of braces, and activity modification. Cortisone injections are also commonly used. Unfortunately, we can never get rid of arthritis. The above mentioned treatment options attempt to keep the pain down to a manageable level. If they do not provide a reasonable amount of relief, then surgery may be indicated.

Diagnosis is made by performing a physical exam of the foot and the use of x-rays. In early stages of the condition x-rays may be normal. In later stages of the condition, narrowing of the joint and/or bone spurs may be evident.

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