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Rheumatoid arthritis


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Rheumatoid arthritis

  1. 1. RHEUMATOID ARTHRITISIN THE FOOT AND ANKLEWhat is Rheumatoid Arthritis? Deformities and conditions Treatment by the Foot and Ankle SurgeonR heumatoid arthritis (RA) is a disease in which certain cells ofthe immune system malfunction and associated with RA may include: • Rheumatoid nodules (lumps)— these cause pain when they While treatment of RA focuses on the medication prescribed by aattack healthy joints. rub against shoes or, if they patients primary doctor or RA causes inflammation in the appearon the bottom of the rheumatologist, the foot and anklelining (synovium) of joints, most foot, pain when walking surgeon will develop a treatmentoften the joints of the hands and feet. • Dislocated toes plan aimed at relieving the pain ofThe signs of inflammation can • Hammertoes RA-related foot problems. The planinclude pain, swelling, redness, and a • Bunions may include one or more of thefeeling of warmth around affected • Heel pain following options:joints. In some patients, chronic • Achilles tendon pain • Orthotic devices. The surgeoninflammation results in damage to • Flatfoot often fits the patient with customthe cartilage and bones in the joint. • Ankle pain orthotic devices to provideSerious damage can lead to cushioning for rheumatoidpermanent joint destruction, How is RA Diagnosed? nodules, minimize pain whendeformity, and disability. Usually a patient has already been walking, and give needed support diagnosed with RA prior to visiting to improve the foot’s mechanics.How Does RA Affect the foot and ankle surgeon. However, • Accommodative shoes. These arethe Foot and Ankle? occasionally a patient first receives used to relieve pressure and painWhen joints become inflamed due a diagnosis of RA from the foot and and assist with RA, the synovium thickens and ankle surgeon. RA is diagnosed • Aspiration of fluid. Whenproduces an excess of joint fluid. on the basis of a clinical examination inflammation flares up in a joint,This overabundance of fluid, along as well as blood tests. the surgeon may aspirate (drawwith inflammatory chemicals To further evaluate the patient’s out) fluid to reduce the swellingreleased by the immune system, foot and ankle problems, the surgeon and pain.cause swelling and damage to the may order x-rays and/or otherjoint’s cartilage and bones. imaging tests. Foot problems caused by RAmost commonly occur in the forefoot(the ball of the foot, near the toes),although RA can also affect otherareas of the foot and ankle. Themost common signs and symptomsof RA-related foot problems—inaddition to the abnormal appearanceof deformities—are pain, swelling,joint stiffness, and difficultywalking.
  2. 2. • Steroid injections. Injections of the foot is relieved through Rheumatoid arthritis in the foot and anti-inflammatory medication may surgery. The foot and ankle ankle can cause considerable pain and be applied directly to an inflamed surgeon will select the procedure deformity, making walking difficult. joint or to a rheumatoid nodule. best suited to the patients Through the treatment approaches• Surgery. Often the pain and condition and lifestyle. selected by the foot and ankle surgeon, deformity associated with RA in substantial relief can be obtained. L This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle Surgeons, a professional society of 6,200 foot and ankle surgeons. Members of the College are Doctors of Podiatric Medicine who have received additional training through surgical residency programs. The mission of the College is to promote superior care of foot and ankle surgical patients through education, research and the promotion of the highest professional standards. Copyright © 2007, American College of Foot and Ankle Surgeons •