Ankle Arthritis: Overview

Ankle Arthritis: Overview

Ankle arthritis causes pain and decreased ankle function due to worn-down cartilage in the joint. Normal joint cartilage provides smooth surfaces for the ankle joint to move, but when the cartilage wears down or becomes damaged, movement becomes painful and limited.

In other weight-bearing joints, like the knee and hip, osteoarthritis commonly occurs when the cartilage wears down over time. Rheumatoid arthritis or other autoimmune diseases can be different causes of cartilage damage in these joints. In the ankle, the most common form of arthritis is post-traumatic arthritis. In this case, a patient suffers a severe injury or trauma to the ankle, which can lead to long-term cartilage damage.

Let's take a look at which bones are affected by ankle arthritis. The bones that are felt on the inside and outside of the ankle are the medial and lateral malleolus, which are the tips of the tibia and fibula bones of the lower leg. The talus sits between these two structures. These three bones make up the ankle joint. The heel bone or calcaneus sits underneath the talus, and these two bones form the subtalar joint. The ankle joint and subtalar joint are collectively called the hind or rear foot.

If a patient gets a bad ankle fracture, the ends of the tibia and fibula are usually the first bones to be injured. Even with surgery to fix the bones, the ankle might not be the same as before the injury. Since the ankle may move a bit differently, the cartilage in the joint can wear down prematurely, causing arthritis.

Whether someone has arthritis from wear and tear over time or if it developed from a previous injury, the symptoms usually look the same. The patient will have pain in their ankle or hindfoot, difficulty walking, and decreased range of motion. The health care provider will check the motion of the foot and ankle. Dorsiflexion and plantar flexion happen at the ankle joint, while inversion and eversion occur at the subtalar joint.

X-rays will be taken to look at the joint space. In a healthy joint without damage, there is a space between the bones on X-ray, representing the thickness of cartilage that is present. In an ankle with arthritis, that space will be thinner, showing that the cartilage is damaged or worn down. If there is no space at all, that means there is no cartilage, and the bones are touching, a condition commonly called bone-on-bone arthritis.

An MRI is usually not needed to evaluate ankle arthritis further since the X-ray will show that the cartilage is wearing away. Looking at the cartilage with an MRI doesn't give much more information. Arthritis of the ankle or hindfoot can cause significant pain and prevent patients from performing their normal daily activities.

Most patients will seek some treatment to decrease the pain and make it easier to go about their day. There are many different types of treatment, and many factors need to be considered. A detailed discussion with the healthcare provider will help put the patient on the road to recovery.