Rheumatoid arthritis is a systemic arthritic condition that can affect joints throughout the entire body. In the foot and ankle we see this cause several different problems.
Rheumatoid arthritis typically causes ulnar deviation in the fingers and hands and this also happens in the feet, which we call fibular deviation. This happens when all the toes over time start to drift to a more lateral position.
We see people with long-standing rheumatoid arthritis typically present with pretty severe hallux valgus or bunion deformities and they also get arthritis in the big toe joint. They typically will also have chronic metatarsalgia or pain over the ball of the foot which is partially from the deviation of the toes and also partially happens as we get older and lose the metatarsal fat pad.
If this happens, we typically try shoe modifications and custom orthotics first, and it is important to see a rheumatologist to make sure you are on the right medications to try and control the increased inflammation throughout the body.
If these treatments do not work, we typically recommend a procedure where we performed arthrodesis or fusion of the first metatarsophalangeal joint and then also perform a second through fifth metatarsal head resection. This is very successful at getting rid of the deformities of the toes and also alleviating the pain both from the arthritic first metatarsal phalangeal joint and also from the prominent bones on the lesser metatarsal heads.
The next most common place we see arthritis develop in patients with rheumatoid arthritis is the ankle. Ankle fusion or arthrodesis used to be considered the gold standard to treat this, but we now have ankle replacements that are options for patients who want to try to preserve range of motion through the ankle joint with ambulation.
If you are suffering from any foot and ankle pain or trauma, call your expert Colorado Springs foot and ankle surgeons today at 719-488-4664!
