Category: Rheumatology

Gout

Posted on March 8, 2023 by - G, Rheumatology

Gout is a type of arthritis caused by a buildup of uric acid crystals in the joints. It often affects the big toe joint, but can also occur in other joints in the foot and ankle. The symptoms of gout include sudden and intense pain, redness, swelling, and warmth in the affected joint.

Gout is typically managed with a combination of lifestyle changes and medications. Lifestyle changes may include a low-purine diet, limiting alcohol consumption, and staying hydrated. Medications may include non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation, colchicine to reduce inflammation and pain during gout attacks, and urate-lowering therapy to reduce the production of uric acid.

To prevent gout attacks, it is important to maintain a healthy weight, avoid foods high in purines (such as red meat, seafood, and alcohol), and stay hydrated. If you experience symptoms of gout, it is important to see a healthcare provider for an accurate diagnosis and appropriate treatment.

Foot arthritis

Posted on March 8, 2023 by - F, Rheumatology

Foot arthritis is a condition that can affect the joints and tissues of the foot, leading to pain, swelling, stiffness, and decreased mobility. There are several types of arthritis that can affect the foot, including osteoarthritis, rheumatoid arthritis, and gout.

Osteoarthritis is the most common form of arthritis that affects the foot. It occurs when the cartilage that cushions the joints of the foot breaks down over time, leading to pain, stiffness, and decreased range of motion. Risk factors for developing osteoarthritis of the foot include age, genetics, previous foot injuries, and repetitive stress on the foot joints.

Rheumatoid arthritis is an autoimmune disease that can affect the joints of the foot and cause inflammation, pain, and swelling. Gout is a type of arthritis that is caused by a buildup of uric acid crystals in the joints of the foot, leading to sudden, severe pain and swelling.

Treatment for foot arthritis may include a combination of medications, physical therapy, and lifestyle changes. Common medications for arthritis include non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs). Physical therapy can help to improve foot and ankle range of motion, strengthen the muscles of the foot, and reduce pain and inflammation. Lifestyle changes may include wearing supportive shoes, using orthotic inserts, and avoiding activities that cause repetitive stress on the foot.

In some cases, surgery may be necessary to treat foot arthritis. Common surgical procedures for foot arthritis include joint replacement, fusion, and arthroscopy. Joint replacement involves removing the damaged joint and replacing it with an artificial joint. Fusion involves fusing the bones of the joint together to eliminate motion and reduce pain. Arthroscopy is a minimally invasive surgical procedure that uses a small camera to visualise and treat joint problems.

Ganglion

Posted on March 8, 2023 by - G, Pathology, Rheumatology, Tumours

A ganglion cyst is a fluid-filled sac that often appears as a bump on or around joints and tendons, commonly occurring in the wrist and hand. However, ganglion cysts can also develop in the foot, usually at the top of the foot or at the ankle. The cyst is typically round or oval-shaped, and may be soft or firm to the touch. In some cases, the cyst may cause discomfort or pain, especially if it presses against a nearby nerve or tendon. Treatment options for a ganglion cyst include observation, aspiration (draining the fluid with a needle), or surgical removal. However, ganglion cysts may recur after treatment. It’s best to consult a healthcare professional for diagnosis and management of ganglion cysts.

Cortisone injections: what are the benefits and risks?

Posted on March 8, 2023 by - C, Frequently asked questions, Medicines, Pain, Rheumatology, Sports

Cortisone injections, also known as corticosteroid injections, are commonly used to relieve inflammation and pain in various conditions, such as arthritis, tendonitis, bursitis, and other inflammatory conditions. Here are some benefits, risks, complications, and side effects associated with cortisone injections:

Benefits:

  • Rapid pain relief: Cortisone injections can provide rapid pain relief by reducing inflammation and swelling in the affected area.
  • Convenience: Cortisone injections are a simple outpatient procedure that can be performed in a doctor’s office, and patients can usually resume normal activities immediately after the injection.
  • Non-surgical: Cortisone injections can help avoid the need for more invasive treatments, such as surgery.
  • Targeted treatment: Cortisone injections can be administered directly into the affected joint or tissue, providing more targeted treatment.

Risks and Complications:

  • Pain and discomfort: Pain and discomfort at the injection site are common after a cortisone injection and can last for a few days.
  • Infection: There is a risk of infection at the injection site, although this is rare.
  • Tissue damage: Repeated cortisone injections can damage the surrounding tissues, including cartilage, tendons, and ligaments.
  • Temporary flare-up: In some cases, the injection can cause a temporary flare-up of symptoms.
  • Skin discoloration: The injection may cause skin discoloration at the site of the injection.

Side Effects:

  • Elevated blood sugar levels: Cortisone can elevate blood sugar levels, so patients with diabetes should monitor their blood sugar closely after receiving a cortisone injection.
  • Weakening of bones: Repeated cortisone injections can weaken bones, leading to an increased risk of fractures.
  • Weight gain: Cortisone can cause weight gain by increasing appetite and fluid retention.
  • Mood changes: Cortisone can affect mood and cause anxiety, depression, and irritability.

It is important to discuss the potential benefits, risks, complications, and side effects of cortisone injections with a healthcare provider before undergoing the procedure. Cortisone injections should not be used as a long-term treatment and should only be administered as part of a comprehensive treatment plan.

Cortisone injections

Posted on March 8, 2023 by - C, Medicines, Rheumatology, Sports

A cortisone injection is a procedure in which a small amount of corticosteroid medication is injected into the affected area of the foot to reduce inflammation and pain. Cortisone injections are commonly used to treat a variety of foot conditions, including plantar fasciitis, Achilles tendonitis, bursitis, and arthritis.

During the procedure, the foot is first cleaned and numbed with a local anaesthetic. The doctor then uses a small needle to inject the cortisone medication into the affected area of the foot, such as the heel or the ankle. After the injection, the foot may be wrapped in a bandage and the patient may be advised to rest the foot for a period of time.

Cortisone injections can provide significant relief from foot pain, but they are not appropriate for everyone. Individuals who are pregnant, have an infection, or have certain medical conditions may not be candidates for cortisone injections. Additionally, cortisone injections should not be used as a long-term solution for foot pain and should be used in conjunction with other treatments, such as physical therapy and orthotic devices. It is important to discuss the potential risks and benefits of a cortisone injection with a healthcare provider before undergoing the procedure.

Capsulitis of the second toe

Posted on March 8, 2023 by - C, Forefoot, Rheumatology

Capsulitis of the second toe is a condition in which the ligaments surrounding the joint at the base of the second toe become inflamed and weakened. This can cause the toe to shift downward and lead to pain, swelling, and difficulty walking or standing for long periods of time.

The exact cause of capsulitis of the second toe is not always clear, but it is often associated with wearing tight or narrow shoes, repetitive stress or overuse, or a structural abnormality in the foot that puts excess pressure on the second toe. It is also more common in women than men and may be more prevalent in those with a high arch or a long second toe.

Treatment for capsulitis of the second toe typically involves conservative measures such as rest, ice, elevation, and anti-inflammatory medications to reduce pain and swelling. Wearing shoes with a wider toe box and low heels, as well as using metatarsal pads or custom orthotics, can help to redistribute pressure on the foot and relieve symptoms. In more severe cases, a walking cast or immobilisation boot may be necessary to allow the ligaments to heal.

If left untreated, capsulitis of the second toe can lead to progressive deformity and a more severe condition known as a hammertoe. It is important to seek prompt medical attention if you experience persistent pain or swelling in the second toe or any other foot or ankle problems.

Can I drive after my cortisone injection?

Posted on March 8, 2023 by - C, Frequently asked questions, Medicines, Rheumatology

Whilst there is not consensus and advice will vary between practitioners, It is generally recommended to wait at least 24 hours after a cortisone injection in the foot before driving or operating heavy machinery. This is because the injection site may be sore and there may be some temporary numbness or weakness in the foot, which can affect your ability to control the pedals.

Additionally, cortisone is a steroid medication that can cause side effects such as dizziness, fatigue, and blurred vision, which can also impair your ability to drive safely. It is important to discuss any concerns or questions you may have about driving after your cortisone injection with your doctor, who can provide you with specific guidance based on your individual situation.

Ankle arthritis

Posted on March 7, 2023 by - A, Ankle, Rheumatology

Ankle arthritis is a degenerative joint disease that affects the ankle joint, which is the joint that connects the leg to the foot. It is most commonly caused by wear and tear over time, as well as injury or trauma to the ankle joint.

Symptoms of ankle arthritis may include pain, stiffness, swelling, and limited range of motion in the ankle joint. Some people may also experience a grinding sensation or a popping sound when moving the ankle joint.

Treatment for ankle arthritis may depend on the severity of the condition and the patient’s overall health. Non-surgical treatment options may include rest, ice, physical therapy, and the use of pain relievers and anti-inflammatory medications to help alleviate pain and reduce inflammation in the joint. In some cases, the use of braces, orthotic devices or supportive shoes may be necessary to help reduce stress on the affected joint.

Surgical treatment for ankle arthritis may be necessary in more severe cases, particularly if non-surgical treatments have not been successful. Surgery may involve removing damaged tissue from the joint, fusing the affected bones together to provide greater stability and support, or replacing the damaged joint with an artificial joint. Recovery from surgery may require a period of immobilisation and rehabilitation to restore strength and function to the affected joint.