Rheumatoid Arthritis of the Foot

Rheumatoid Arthritis of the Foot

Article
Bone, Muscle, & Joint
Diseases & Conditions
+1
Contributed byMaulik P. Purohit MD MPHJan 14, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Foot Rheumatoid Arthritis

What is Rheumatoid Arthritis of the Foot? (Definition/Background Information)

  • Rheumatoid Arthritis (RA) is a chronic auto-immune systemic inflammatory disorder that may affect the lining of joints, surrounding tissues, or organs within the body.
  • Individuals, who develop RA often experience fatigue, stiffness, and joint pain.
  • Rheumatoid Arthritis of the Foot, affects one or more joints within the foot.

Who gets Rheumatoid Arthritis of the Foot? (Age and Sex Distribution)

  • Rheumatoid Arthritis of the Foot may occur in individuals of all ages, race/ethnic groups, and gender
  • Middle-aged women are known to develop this inflammatory, debilitating, and progressive disorder, at a much higher rate than men

What are the Risk Factors for Rheumatoid Arthritis of the Foot? (Predisposing Factors)

Common risk factors associated with Rheumatoid Arthritis of the Foot include:

  • Adult women have an increased risk of developing this disorder, than men
  • Individuals in the 40-60 year age group
  • Studies have indicated that Rheumatoid Arthritis is more common in individuals with a certain genetic make-up. Individuals having an immediate family member/relative with a history of RA, have an increased risk of developing the disorder
  • Various studies have found that smoking is a key contributing factor for the development of RA

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Rheumatoid Arthritis of the Foot? (Etiology)

  • Rheumatoid Arthritis (of the Foot) occurs when the body immune system attacks the synovial membranes that surround the joints. The resulting inflammation that occurs due an abnormal immune response, causes thickening of the synovial membrane (joint linings)
  • Prolonged inflammation may cause damage to the cartilages and bones of the joint. Due to this, the surrounding tendons and ligaments that hold the joint in place are weakened and stretched, slowly causing the joint to lose its alignment and structure
  • Some individuals are more prone to infections than others. Research has shown that this may be due to the presence of certain type of genes in them. Infections with certain viruses and bacteria may trigger the development of Rheumatoid Arthritis
  • Hence, it has been suggested, that individuals with such genes may have a higher risk of developing RA. Research is currently being undertaken to understand better, the genetic risks involved in this autoimmune disorder 

What are the Signs and Symptoms of Rheumatoid Arthritis of the Foot?

Signs and symptoms of Foot Rheumatoid Arthritis include:

  • Noticeable swelling and tenderness in the foot joints, decreased range of motion
  • Feeling of weakness, loss of weight
  • Prolonged stiffness of the joints, especially observed in the mornings (that may improve during the day, due to use of the limbs)
  • Elevated body temperatures
  • Deformity of the foot
  • Often, both feet may be affected, indicating a symmetrical pattern of the condition

How is Rheumatoid Arthritis of the Foot Diagnosed?

Early-stage diagnosis of Rheumatoid Arthritis of the Foot can sometimes be difficult, often due to the symptoms resembling other conditions. There are a variety of diagnostic tests that a physician may use to diagnose RA, which include:

  • Physical examination: The physician will perform a thorough physical examination to determine, if the individual has RA of the Foot. In addition to this, a complete medical history may aid in arriving at a definitive diagnosis. The physician will also check the joints for swelling, redness, tenderness, its reflexes and muscle strength
  • X-rays: X-rays use radiation to produce images of the joints. This can help your physician rule out other possible causes of joint discomfort
  • Blood test: During the blood test, a needle is used to obtain blood samples from an artery or vein, which are then sent to a laboratory for analysis
  • Joint fluid analysis: Occasionally, fluid may accumulate around a joint, resulting in pain and disability. Analysis of such joints may provide evidence regarding the cause of joint fluid accumulation. A needle is inserted into the joint space, and the fluid aspirated with a syringe. The aspirated fluid is sent for a laboratory analysis; the tests a laboratory may perform include:
    • Analyzing what cells are present in the joint fluid
    • Chemical composition of the fluid
    • Examinations of the fluid under a microscope for the presence of crystals
    • If an infection is suspected as the cause for fluid accumulation, then a joint fluid culture may be performed, to remove fluid from the joint
  • General ultrasound imaging: Ultrasounds are high-frequency sound waves that generate a more detailed image of the joint

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Rheumatoid Arthritis of the Foot?

  • Rheumatoid Arthritis is a progressive inflammatory disorder that progressively worsens over time
  • Chronic pain and stiffness within the foot may prevent individuals from completing their routine daily activities
  • However, some rheumatoid arthritis cases may cause permanent disability

How is Rheumatoid Arthritis of the Foot Treated?

Currently, the exact underlying cause of Rheumatoid Arthritis (of the Foot) is unknown. Although, conservative nonsurgical treatments may be used to help to reduce pain and improve range of motion within the joint. These include:

  • Any activity that aggravates the foot condition should be avoided. The physician may advise the individual to refrain from participating in any physical activities, till the pain or symptoms get better
  • Applying ice (or a damp heated towel) to the foot can help reduce pain and swelling
  • Use of specific assistive devices, such as a cane or walker is recommended. This may help individuals perform some of their basic everyday activities
  • The physician may prescribe a well-padded custom-made shoe, in order to relieve pain and help improve one’s ability to walk
  • Non-steroidal anti-inflammatory oral medications, such as Ibuprofen and naproxen, may be used to treat Rheumatoid Arthritis of the Foot. These medications may help decrease the pain and joint swelling
  • Corticosteroid injections help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged episodes of such injections, may injure the joints in the long-run
  • Any physical therapy exercises that could aid in strengthening and improving the flexibility of the joints of the feet, and also help reduce discomfort. These are generally used, only after the signs and symptoms have been controlled or decreased

Surgical treatment measures could include:

  • Arthroscopic chondroplasty: Arthroscopic chondroplasty is a surgical intervention technique that involves repairing the damaged cartilage within the joint; thus allowing the growth of healthy tissue in its place. This surgical procedure is performed using an orthopedic device, called an arthroscope, and is useful in treating mild to moderate Rheumatoid Arthritis
  • Joint fusion: Joint fusion is a surgical technique that involves the removal of the arthritic part within the affected joint, and fusing the surrounding bones together. The purpose of this procedure is to relieve pain, stabilize the joint, and regain some range of motion, within the joint
  • Total arthroplasty: Total arthroplasty involves the complete removal of cartilage within a joint. The joint is then removed and replaced by a metal and plastic prosthetic implant. A physician will recommend this surgical procedure, if the inflammatory disorder affects the entire foot

How can Rheumatoid Arthritis of the Foot be Prevented?

  • Currently, there are no preventable measures associated with Rheumatoid Arthritis of the Foot.
  • If there is an early, aggressive, and proper treatment of this inflammatory disorder, then the progression of this disabling condition, could be slowed down or decreased

What is the Prognosis of Rheumatoid Arthritis of the Foot? (Outcomes/Resolutions)

  • The long-term prognosis of Rheumatoid Arthritis of the Foot depends on the severity of this inflammatory disorder
  • If during the early stages, proper and aggressive treatment of RA is undertaken, then the condition in some patients may show an improvement, without giving rise to any serious complications
  • Other factors that determine the course of outcome of the condition include, if this disorder is in a flared-up state, in an arthritic remission period, or whether it was correctly controlled with treatment
  • A high percentage of individuals, who develop Rheumatoid Arthritis, may experience a lifetime of gradual inflammation, associated with this debilitating disorder

Additional and Relevant Useful Information for Rheumatoid Arthritis of the Foot:

Unlike the degeneration of cartilage associated with osteoarthritis, Rheumatoid Arthritis affects the lining of the joint.

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Maulik P. Purohit MD MPH picture
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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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