Foot & Ankle Arthritis

The human foot contains 33 joints, which work together to provide stability, flexibility, and movement. These joints are classified into several key groups:

1. Ankle Joint (Tibiotalar Joint) – Connects the lower leg bones (tibia and fibula) to the talus bone, allowing the foot to move up and down. The talus is a small but essential bone in the ankle that plays a key role in foot and leg movement.
2. Subtalar Joint – Located beneath the ankle joint, this joint allows for side-to-side motion and helps adapt to uneven surfaces.
3. Midfoot Joints (Tarsometatarsal Joints and Transverse Tarsal Joint) – These joints connect the hindfoot to the forefoot and contribute to arch stability and shock absorption.
4. Metatarsophalangeal (MTP) Joints – These joints connect the toes to the rest of the foot and play a key role in walking and balance.
5. Interphalangeal Joints – Found in the toes, these joints allow bending and flexibility for movement.

Each joint plays a specific role in providing movement and absorbing impact, helping the foot function efficiently during daily activities

There are several types of arthritis that can affect the foot and ankle. The most common forms include osteoarthritis (OA), which results from wear and tear on the joints, rheumatoid arthritis (RA), which is an autoimmune condition that causes joint inflammation, and post-traumatic arthritis, which develops after an injury such as a fracture or ligament tear.

Four common types of arthritis that affect the foot and ankle include:

1. Hallux Rigidus (Big Toe Arthritis)
2. Ankle Arthritis
3. Midfoot Arthritis
4. Subtalar Arthritis

Each of these conditions affects different parts of the foot and ankle, presenting unique challenges and treatment considerations.

Hallux Rigidus (Big Toe Arthritis)

Hallux rigidus is a form of arthritis that affects the first metatarsophalangeal (MTP) joint at the base of the big toe. It is a progressive condition that leads to stiffness, pain, and limited movement in the toe. Hallux rigidus typically develops due to repetitive stress on the joint, previous trauma, or structural abnormalities that increase pressure on the big toe joint.

Symptoms of Hallux Rigidus include:

• Pain and stiffness in the big toe, particularly during walking or standing
• Swelling around the joint
• Difficulty bending the toe upward (dorsiflexion) or downward (plantarflexion)
• Development of bone spurs on the top of the joint, leading to a visible bump

Ankle Arthritis

Ankle arthritis is a degenerative condition that affects the tibiotalar joint, where the shinbone (tibia) meets the talus bone. Ankle arthritis is less common than knee or hip arthritis but can be equally debilitating. It often results from prior ankle injuries such as fractures, ligament tears, or chronic instability, leading to post-traumatic arthritis. Other causes include rheumatoid arthritis and osteoarthritis.

Symptoms of ankle arthritis include:

• Pain and swelling in the ankle joint
• Stiffness and reduced range of motion
• Difficulty walking on uneven surfaces or inclines
• Increased discomfort with activity, relieved by rest

Midfoot Arthritis

Midfoot arthritis affects the joints in the middle of the foot, which include the tarsometatarsal (TMT) joints. This type of arthritis commonly develops due to wear and tear, previous fractures, or inflammatory conditions like rheumatoid arthritis. Midfoot arthritis can lead to difficulty with daily activities, as the midfoot plays a critical role in weight-bearing and walking mechanics.

Symptoms of midfoot arthritis include:

• Pain and stiffness in the middle of the foot
• Swelling over the top of the foot
• Increased discomfort when pushing off the foot while walking
• Development of bone spurs that may cause visible deformity

Subtalar Arthritis

Subtalar arthritis affects the subtalar joint, located between the talus and calcaneus (heel bone). This joint plays a key role in foot movement, particularly in side-to-side motion and adapting to uneven terrain. Subtalar arthritis often results from prior injuries such as calcaneal fractures or chronic instability.

Symptoms of subtalar arthritis include:

• Pain on the outer or inner side of the ankle
• Stiffness and difficulty walking on uneven ground
• Swelling around the joint
• Reduced ability to move the foot side to side

Diagnosing foot and ankle arthritis involves a combination of medical history, physical examination, and imaging studies. X-rays are commonly used to assess joint space narrowing, bone spurs, and deformities. In some cases, advanced imaging such as MRI or CT scans may be required to evaluate the extent of joint damage.

Foot and ankle arthritis can significantly impact daily activities, making simple tasks such as walking or standing painful. Understanding the specific type of arthritis affecting the foot and ankle is essential for choosing the most appropriate treatment plan.