While problems with the ankle are relatively common, primary osteoarthritis rarely occurs in the ankle. When ankle osteoarthritis does occur, it is usually caused by a remote significant trauma. When you think you have osteoarthritis of the ankle, your priority should be to rule out other more common or serious conditions. The following guide describes symptoms of ankle osteoarthritis as well as other ankle conditions that can be mistaken for osteoarthritis.
Pain
Pain is one of the most common symptoms associated with arthritis. A key point is that arthritis, by definition, is a disease involving the joint. Thus, pain with flexing or extending the ankle joint itself may suggest arthritis. However, pain only when palpating around the ankle suggests a problem outside the joint, such as a tendon dysfunction. Pain from within the ankle is usually felt anteriorly but some arthritis patients have difficulty localizing the pain.
Swelling
Minor swelling that waxes and wanes may be a sign of ankle osteoarthritis. However, significant swelling of the ankle suggests other types of arthritis. These conditions may cause significant damage if left untreated. Chronic conditions that can cause ankle swelling include rheumatoid arthritis, chronic gout and certain chronic infections. Conditions that cause acute swelling and pain include gout, trauma and various infections. Typically these acute conditions result in severe pain such that many patients present to the emergency room.
Stiffness
Arthritis commonly causes joint stiffness especially in the morning. As a general rule, osteoarthritis causes morning stiffness for 30 minutes or less. When stiffness lasts longer especially in combination with significant swelling, an inflammatory arthritis must be considered such as gout or an infection.
Neuropathy
The presence of decreased foot sensation and chronic ankle symptoms may indicate a neuropathic joint (also known as a Charcot joint). A neuropathic joint is one that has undergone degenerative changes as a result of repeated trauma, often unbeknownst to the patient who has a problem with sensation. One cause of neuropathic joints in the lower extremities is diabetes, which can affect sensory nerves.
Other conditions
There are numerous ankle conditions that cause non-arthritic pain. Pain localizing only to the heel, side or back of the ankle typically are not due to arthritis. Examples of conditions that cause non-arthritic ankle pain include tendon dysfunction, nerve impingement, bursitis and subtalar coalition, according to podiatrist William M. Jenkin, DPM. Because it can be difficult to distinguish between these conditions and the various types of arthritis, consult your physician if you are suffering from ankle discomfort.
References
- "Approach to the Patient with Ankle and Foot Pain" in Current Rheumatology Diagnosis and Treatment, 2nd Edition; William M. Jenkin, DPM; 2007
