Causes

Arthritis commonly affects the ankle joint. Osteoarthritis is the most common cause and is usually after a previous injury, but may occur out of the blue. An inflammatory condition such as rheumatoid arthritis can affect the ankle. The treatment will aim to reduce the inflammation around the joint, prevent further damage and alleviate the effects of any deformity. The precise treatment will depend on the precise location and the severity.

Diagnosis

Standing X-rays are essential and some blood tests may be needed to check for rheumatoid arthritis. However advanced imaging is usually the key, especially computed tomography (CT) scans, or magnetic resonance imaging (MRI) or a bone scan (SPECT). In complex cases the precise injection of steroids under image guidance can give temporary relief and confirm the site of the damage. This will suggest the effectiveness of any permanent surgical treatment.

Treatment

The full benefit of non-operative treatments such as insoles, pads, shoes, physiotherapy and medicines will need to be assessed before embarking on surgery. An injection of steroids into the worn ankle joint can often provide excellent pain relief for some months.

Surgery

In early ankle arthritis, a catching pain, restricted movement or intermittent locking may be helped by minimally invasive technique of arthroscopic surgery. The gold standard technique has been fusion of the ankle (the two bones grow into one) where the painful grinding movements are eradicated. This is also performed using a minimally invasive technique.

Some patients may benefit from a total ankle replacement.

More information is available from the versusarthritis.org