Category: Rheumatology

Sinus tarsi syndrome

Posted on April 11, 2023 by Steve - Hindfoot, Rheumatology, S

Sinus tarsi syndrome is a condition that affects the foot and ankle. It is characterized by pain and discomfort in the sinus tarsi, which is a small bony canal located between the talus bone (ankle bone) and the calcaneus bone (heel bone). The sinus tarsi serves as a passage for nerves, blood vessels, and ligaments that are important for foot and ankle function.

Sinus tarsi syndrome is typically caused by injury or trauma to the foot and ankle, such as ankle sprains, repetitive overuse, or chronic instability. Other potential causes can include arthritis, ligamentous laxity, or anatomical variations that lead to compression or irritation of the nerves or tissues within the sinus tarsi.

Symptoms of sinus tarsi syndrome may include:

Pain: Pain in the lateral (outer) aspect of the foot, specifically in the area of the sinus tarsi, is the hallmark symptom of this condition. The pain may be sharp or dull and may worsen with weight-bearing activities or prolonged standing.
Swelling: Swelling around the sinus tarsi may be present, although it is usually mild compared to other foot and ankle conditions.
Tenderness: Tenderness to touch over the sinus tarsi area may be present, and pressure on the area may exacerbate the pain.
Instability: Some patients with sinus tarsi syndrome may experience a feeling of instability or a sense of “giving way” in the foot or ankle.
Limited range of motion: Reduced range of motion in the ankle joint may be observed, particularly with movements that involve inversion (inward rolling) or eversion (outward rolling) of the foot.

Diagnosis of sinus tarsi syndrome typically involves a thorough clinical evaluation by a healthcare provider, including a physical examination, assessment of medical history, and imaging studies such as X-rays or MRI to rule out other potential causes of foot and ankle pain.

Treatment for sinus tarsi syndrome may include conservative measures such as rest, ice, compression, and elevation (RICE), nonsteroidal anti-inflammatory drugs (NSAIDs), orthotics or shoe modifications, physical therapy, and activity modification. In some cases, corticosteroid injections may be used to reduce inflammation and alleviate pain. If conservative measures are not effective, more advanced treatments such as extracorporeal shockwave therapy, prolotherapy, or platelet-rich plasma (PRP) injections may be considered. In rare cases, surgical intervention may be necessary to address any underlying structural issues or persistent symptoms.

It is important to consult with a qualified healthcare provider for an accurate diagnosis and appropriate treatment plan if you suspect you may have sinus tarsi syndrome or are experiencing foot and ankle pain.

Synovitis

Posted on March 9, 2023 by Steve - Rheumatology, S

Synovitis is a condition that occurs when the synovial membrane, which lines the joints, becomes inflamed. This inflammation can cause pain, swelling, stiffness, and restricted movement in the affected joint.

There are many different causes of synovitis, including:

Rheumatoid arthritis: This is an autoimmune disorder that causes the body’s immune system to attack the synovial membrane.
Osteoarthritis: This is a degenerative joint disease that can cause the synovial membrane to become inflamed.
Gout: This is a type of arthritis that occurs when uric acid crystals build up in the joint, causing inflammation.
Infection: Infection in the joint can cause synovitis.
Injury: An injury to the joint can cause the synovial membrane to become inflamed.

Treatment for synovitis depends on the underlying cause. In many cases, anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), can help reduce inflammation and relieve pain. Other treatments may include physical therapy, joint injections, and surgery in severe cases.

It is important to seek medical attention if you suspect you have synovitis or if you experience persistent joint pain or swelling, as untreated synovitis can lead to joint damage and long-term joint problems.

Septic arthritis

Posted on March 9, 2023 by Steve - Infections, Rheumatology, S

Septic arthritis in the foot is a serious condition in which a joint in the foot becomes infected with bacteria. The infection can cause pain, swelling, redness, and warmth in the affected joint. If left untreated, septic arthritis can cause permanent joint damage and even spread to other parts of the body.

Septic arthritis in the foot is usually caused by bacteria that enter the joint through a wound or cut in the skin. People with a weakened immune system, such as those with diabetes or HIV, are at an increased risk of developing septic arthritis.

Treatment for septic arthritis in the foot typically involves a combination of antibiotics and drainage of the infected joint. In some cases, surgery may be necessary to remove infected tissue or repair joint damage. It is important to seek medical attention as soon as possible if you suspect you have septic arthritis in the foot.

Prevention is key when it comes to septic arthritis in the foot. You can reduce your risk of developing this condition by practicing good foot hygiene, avoiding sharing shoes or socks with others, and properly cleaning and caring for any cuts or wounds on your feet. Additionally, people with a weakened immune system should take extra precautions to protect their feet, such as wearing protective footwear and regularly inspecting their feet for signs of infection.

Rheumatoid arthritis and the foot

Posted on March 9, 2023 by Steve - R, Rheumatology

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation in the joints, which can lead to pain, swelling, stiffness, and deformity. RA can affect any joint in the body, including those in the foot and ankle. When RA affects the foot and ankle, it can cause significant pain and difficulty walking.

Treatment for RA in the foot and ankle may include a combination of medication, physical therapy, and surgery. Medications used to treat RA may include non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), and biologic drugs. Physical therapy can help improve range of motion, strength, and balance, as well as reduce pain and swelling.

Surgery may be necessary in cases where non-surgical treatments have failed or when there is significant joint damage. Surgical options may include joint fusion or joint replacement.

It is important to work with a healthcare professional, such as a rheumatologist or podiatrist, to develop a personalised treatment plan based on the individual’s specific needs. Early treatment can help slow the progression of RA and reduce the risk of joint damage and deformity.

Psoriatic arthritis

Posted on March 9, 2023 by Steve - P, Rheumatology

Psoriatic arthritis is a type of inflammatory arthritis that can affect people who have psoriasis, a chronic autoimmune skin condition. Psoriatic arthritis typically causes joint pain, stiffness, and swelling, and can affect any joint in the body, including the feet and ankles.

Symptoms of psoriatic arthritis in the feet may include pain, swelling, and stiffness in the joints, as well as changes to the nails such as pitting, thickening, or separation from the nail bed. In some cases, psoriatic arthritis can cause joint deformities, especially if left untreated.

The diagnosis of psoriatic arthritis is usually made based on the patient’s medical history, physical examination, and imaging studies such as X-rays or MRI. Blood tests may also be used to help confirm the diagnosis and rule out other conditions.

Treatment of psoriatic arthritis in the feet may include a combination of medications such as non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), biologics, and corticosteroids. Physical therapy and exercise may also be recommended to improve joint mobility and strengthen the muscles around the affected joints.

It is important for people with psoriatic arthritis to take good care of their feet and to see a podiatrist regularly for foot exams and treatment. This may include wearing appropriate footwear, using orthotics or other supportive devices, and maintaining good foot hygiene to prevent infections and other complications.

Overall, psoriatic arthritis is a chronic condition that requires ongoing management and treatment to control symptoms and prevent complications. Working with a healthcare provider can help develop an individualised treatment plan that meets the specific needs of the patient.

Pseudo-gout

Posted on March 9, 2023 by Steve - P, Rheumatology

Pseudo-gout is a type of arthritis that is caused by the buildup of calcium pyrophosphate crystals in the joints. It is called “pseudo” because it is similar in presentation and symptoms to gout, but the crystals involved are different.

The symptoms of pseudo-gout are similar to those of gout, including sudden onset of joint pain, swelling, and warmth. Pseudo-gout most commonly affects the knees, but it can also affect other joints such as the ankles, wrists, and shoulders.

Risk factors for pseudo-gout include older age, joint injury, and certain medical conditions such as hyperparathyroidism and hemochrombtosis. The diagnosis of pseudo-gout is typically made by analysing joint fluid obtained through a joint aspiration procedure.

Treatment of pseudo-gout may include non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation, as well as colchicine or corticosteroids to reduce inflammation and prevent further crystal formation. In some cases, joint aspiration or surgery may be necessary to remove excess fluid or damaged tissue.

Pseudo-gout is a chronic condition that can cause significant pain and disability, so it is important to work with a healthcare provider to develop an individualised treatment plan to manage symptoms and prevent complications.

Midfoot arthritis

Posted on March 9, 2023 by Steve - M, Midfoot, Rheumatology

Midfoot arthritis is a condition characterized by pain and stiffness in the midfoot area, which includes the arch and the ball of the foot. It can be caused by wear and tear of the joints in the midfoot, rheumatoid arthritis, or trauma to the foot. Symptoms may include pain, swelling, stiffness, and difficulty walking or standing. Treatment options for midfoot arthritis may include over-the-counter or prescription pain relievers, physical therapy, shoe inserts or custom orthotics, and in severe cases, surgery to fuse the affected joints together or remove the damaged joints and replace them with an artificial joint. It is important to seek medical attention if you experience persistent foot pain or discomfort.

Joint swelling in the foot

Posted on March 8, 2023 by Steve - J, Rheumatology

Joint swelling in the foot can be caused by various conditions, including arthritis, gout, and infections. Here are some common causes and symptoms of joint swelling in the foot:

Arthritis: Arthritis is a common cause of joint swelling in the foot. Rheumatoid arthritis, osteoarthritis, and psoriatic arthritis can all cause joint swelling and pain in the foot. Symptoms of arthritis in the foot include stiffness, pain, swelling, and difficulty moving the joint.
Gout: Gout is a type of arthritis that is caused by a buildup of uric acid in the body. The uric acid can form crystals in the joint, causing inflammation, swelling, and pain. Symptoms of gout in the foot include severe pain, redness, and swelling in the affected joint.
Infections: Infections can cause joint swelling and pain in the foot. Cellulitis, a bacterial skin infection, can spread to the joints and cause swelling and pain. Septic arthritis, a bacterial infection of the joint, can also cause joint swelling and pain.
Trauma: Trauma to the foot, such as a sprain or fracture, can cause joint swelling and pain.

If you are experiencing joint swelling in your foot, it is important to see a healthcare professional for an evaluation. Treatment will depend on the underlying cause of the joint swelling.

Joint pain in the foot

Posted on March 8, 2023 by Steve - J, Rheumatology

Joint pain in the foot can be caused by a variety of conditions, including arthritis, gout, and bursitis. These conditions can cause inflammation, stiffness, and pain in the joints of the foot, making it difficult to walk, run, or engage in other physical activities.

Arthritis is a common cause of joint pain in the foot and can occur in various forms, including osteoarthritis, rheumatoid arthritis, and psoriatic arthritis. Gout is another common cause of joint pain, which is caused by the buildup of uric acid crystals in the joints. Bursitis, which is the inflammation of the bursae (fluid-filled sacs that cushion the joints), can also cause joint pain in the foot.

Treatment for joint pain in the foot may vary depending on the underlying cause and severity of the pain. Conservative treatments may include rest, ice, compression, and elevation (RICE), physical therapy, anti-inflammatory medication, or corticosteroid injections. In more severe cases, surgery may be necessary to correct the problem.

It is important to consult with a healthcare professional for an accurate diagnosis and treatment plan if you are experiencing joint pain in your foot.

Hallux rigidus

Posted on March 8, 2023 by Steve - Forefoot, H, Rheumatology

Hallux rigidus is a type of arthritis that affects the big toe joint. It occurs when there is damage or degeneration of the cartilage that covers the ends of the bones in the joint, leading to pain, stiffness, and limited range of motion in the big toe.

Symptoms of hallux rigidus include pain and stiffness in the big toe joint, especially during activities such as walking, running, and climbing stairs. There may also be swelling and tenderness in the joint, and the toe may become crooked or appear larger than normal.

Treatment for hallux rigidus depends on the severity of the condition and may include conservative measures such as wearing shoes with a wide toe box and cushioned soles, using custom orthotics to support the foot and reduce pressure on the joint, and taking non-steroidal anti-inflammatory medications (NSAIDs) to relieve pain and reduce inflammation.

If conservative measures are not effective, surgery may be necessary to remove bone spurs, replace or fuse the joint, or realign the toe. In severe cases where joint replacement or fusion is required, physical therapy and rehabilitation may be necessary to help restore function and mobility.

Early diagnosis and treatment are important for preventing the progression of hallux rigidus and preserving joint function. If you are experiencing symptoms of hallux rigidus, it is important to seek medical attention for an accurate diagnosis and appropriate treatment.