Ankle arthritis is a degenerative disease and dystrophy of the structures of the musculoskeletal system. Affects the lower limbs. It is considered one of the most common forms of joint disease: it accounts for up to 30% of all cases of degenerative-dystrophic joint damage. The pathological process occurs not only in elderly patients. About a quarter of the patients are under 40 years old.
This disorder is accompanied by persistent pain and progressive loss of function of the joints and lower limbs. Without treatment, it will progress and not go away on its own. Diagnosis and treatment of disorders is the job of an orthopedist (depending on the cause, with the participation of a traumatologist, as well as a physiotherapist and physiotherapist).
Causes of ankle arthritis
Osteoarthritis is considered a multimorbidity disease. Its development occurs due to the influence of a group of causes. With age, the number of pathogenic factors increases, so the likelihood of a pathological process also increases. But not everything is so simple.
Pathogenesis of the disorder
There are a group of causes of ankle arthritis, the most common of which are:
- unreasonable physical activity;
- injury;
- work;
- metabolic diseases;
- uncomfortable shoes;
- other diseases of the musculoskeletal system;
- Rheumatism.
Unreasonable stress can be a result of lifestyle or a consequence of career choices. Continuous walking, standing in one place, carrying heavy objects, high-intensity activities. All of these are provoking agents of the pathological process in the medium term (several years).
Another reason is trauma, especially intra-articular fractures, dislocations and also severe bruises (to a lesser extent). Ankle arthritis manifests unnoticed but continues to progress. Often patients underestimate the consequences of the injury they have suffered.
Surgery can cause arthritis. However, such complications are relatively rare. Mainly due to misassessment of the clinical condition. The doctor's professional qualifications are not enough.
Metabolic diseases, such as diabetes, can cause the disorder. However, more often the cause of ankle arthritis is gout, as well as hormonal disorders (for example, during menopause).
Uncomfortable shoes are one of the main factors in the development of the pathological process. The disorder develops due to improper distribution of the load on the foot. Often complex disorders develop: not only arthritis, but also spinal injuries. At a minimum - osteoarthritis. But more dangerous problems can also occur.
Functional disorders of the musculoskeletal system themselves also increase the likelihood of a pathological process. Herniated discs, cartilage degeneration, and congenital disorders create additional risks.
Rheumatism is manifested by arthritis and systemic lupus erythematosus. Lesions of a degenerative-dystrophic nature are secondary, but they aggravate the underlying disease and worsen the prognosis.
Ankle arthritis is a multifactorial disease. As a rule, it develops under the influence of many causes at once. There are exceptions, but they are very rare. In addition, the number of factors affects the severity of the disease and the rate of progression of the pathological process.
The development of the pathological process is stepwise. In the early stages, local blood circulation and the distribution of dynamic loads on the foot are disrupted. Gradually, cartilage-destructive processes are added. Inflammation slowly begins. Degeneration of other structures of the ankle occurs: joint capsule, ligaments, bones, etc. The more the disease progresses, the more difficult it is to treat. It requires more effort and time.
Factors that increase the risk of developing joint disease
Dystrophic destruction of the tissues of the ankle joint occurs not only due to the influence of direct causes. The severity, likelihood, and course of the disease are influenced by risk factors. They complete the picture of the violation. Among them:
- habit of wearing high heels;
- the physically difficult nature of the work (including occupations with unclear risks: teachers, chefs also get sick);
- previous injury to the ankle joint (there are cases where the disorder manifests itself many years after the injury);
- history of endocrine disease (hormone disorders create additional risks);
- history of musculoskeletal disease;
- age 40+ (although the disease also occurs in younger people);
- increased body weight;
- gender (women get the disease more often than men).
Ankle osteoarthritis is a slow-developing disease, symptoms do not appear immediately. Therefore, it is difficult to assess which risk factors and causes contribute to the pathological process. It is necessary to collect a complete medical history.
Classification and types of ankle joint injuries
Pathology is classified on two bases.
The first criterion is the origin of the pathological process. Highlights:
- post-traumatic form of the disorder (develops after injury to the ankle joint or other structures of the musculoskeletal system);
- ankle joint deformity: consequence of metabolic disorders or trauma, accompanied by slow but steady joint deformity;
- Metabolic arthritis develops against the background of diabetes, hormonal disorders or gout (purine metabolism disorder).
The second basis for classification is based on the stage of the pathological process. During its development, ankle arthritis goes through the following stages:
- initial or early;
- progressive;
- progressive joint disease.
In the first stages, there is no clinical picture or appears after intense physical activity. The pathological process is detected only with the help of special diagnostic methods.
The progressive stage of the disorder is accompanied by intensification of the clinic. Symptoms appear after light physical activity. Reduced load capacity. There is a syndrome of constant pain, as well as limited mobility of the leg in the ankle joint.
The final stage of the pathological process is accompanied by severe pain, as well as other symptoms in a state of complete rest. Both support and motor functions are impaired. Often a person becomes disabled. Complex surgical treatment, including endoscopy, is required.
Important!
Staging plays the biggest role in determining treatment tactics and predicting the course and outcome of the disease. This disorder is best treated in the early stages. The more the disease progresses, the more difficult and time-consuming correction becomes.
Symptoms of the disorder
The clinical picture depends on the form and stage of the pathological process. Typical manifestations are:
- pain;
- Tired;
- no mercy;
- swelling;
- dysfunction of the support function of the legs;
- muscle weakness.
Pain in the legs is initially observed only after intense physical activity. Then a small operation is enough. At advanced stages of the pathological process, pain is always present, regardless of load.
Fatigue is observed from the early stages of the disorder. Feelings of muscle weakness and fatigue gradually increase with the disease. Signs indicate further development of the disorder.
Exercise tolerance also gradually decreases. At the stage of pronounced disorders, a person cannot go to the second or third floor. We must stop.
Swelling is a sign that is always present. The leg at the ankle looks puffy and enlarged. This is a non-specific manifestation.
The onset of pain is typical. After a long period of time in one place, severe joint stiffness will develop. The first movements cause a lot of discomfort. The pain and discomfort gradually disappear as the patient continues to move.
The clinical picture depends on the degree of ankle osteoarthritis. Plays a large role in determining the stage and severity of the pathological process. The doctor systematizes the symptoms through oral questioning and taking medical history.
The disease is characterized by a chronic process. In the severe stages of the disease, signs of ankle osteoarthritis appear most clearly. In the chronic phase, remission is only partial. The clinic wasn't too bright, but the symptoms didn't completely go away. Then, a new, more severe arthritis in the ankle joint occurred, and the symptoms became more intense again. And so on in a circle until quality processing is carried out.
Complications of ankle arthritis
Complications of the pathological process involve maintaining the ability to work and the ability to care for oneself.
The patient has an ankle deformity. The pathological process ends with the formation of contractures, areas of primary or complete immobility of the limb at the ankle. The situation can only be corrected with surgery.
At times of exacerbation, the development of synovitis and bursitis is typical. This condition lasts several weeks and in the acute course it completely eliminates the ability to work and move.
The final result of the pathological process is a deterioration and then complete loss of the supporting function of the legs, the patient is unable to move normally. You must use crutches. Complete loss of ability to work and, in some cases, loss of ability to care for oneself. In the advanced stages of ankle arthritis, the patient becomes disabled.
Diagnostic
Diagnosis of damage to joint structures and cartilage tissue is carried out under the supervision of an orthopedic traumatologist. Exams are typical. It is not difficult to determine the pathological process as well as its severity. Among the techniques:
- Question the patient orally to better understand the nature of symptoms and health complaints;
- collect a history, allowing you to determine the possible origin of the medical condition;
- palpation: arthritis is manifested by deformation, swelling, pain during passive movements;
- Ankle X-ray: a routine examination that provides sufficient information to diagnose and determine its severity, considered the gold standard examination;
- MRI if radiological data are insufficient.
Other studies may be conducted. For example, computed tomography (arthritis affects not only cartilage, but also bones; CT allows detailed, accurate visualization of the nature of the disorders).
Note!
Arthritis has no specific symptoms, especially in the early stages. Therefore, if you do not have enough knowledge, you will not be able to distinguish pathological processes from each other. Special diagnostic instruments are needed.
Laboratory diagnostic techniques provide little data. They only provide information in terms of determining the inflammatory process and help diagnose certain forms of joint diseases (metabolic origin, rheumatic nature).
Treatments
Treatment of ankle arthritis is performed using conservative and surgical techniques. The best results can be achieved if you use a complex editing method.
Conservative therapy includes the use of medication, exercise therapy, and physical therapy with massage. The following drugs are used:
- local anti-inflammatory;
- conventional anti-inflammatory drugs (in the form of tablets or injectable solutions);
- chondroprotector;
- Nicotinic acid and other means to improve metabolism.
Exercise therapy and physical therapy, along with massage, are aimed at recovery after the acute condition is eliminated. These methods are very significant during remission. If the disease occurs in an acute form with pronounced clinical symptoms, treatment methods will be postponed.
Surgical treatment is necessary for persistent deformities and misalignments in the joint anatomy. It is possible to have arthroplasty or arthroscopy, replacing the joint with an artificial analogue. This is a high-tech editing method.
Forecast
Prognosis depends on the time of treatment, health status, cause of joint disease as well as the degree of development of the disease. The more the disease progresses, the more complicated the condition becomes. If treatment is started early, the outlook for cure and full recovery is good. In other cases, surgery and a long recovery period are required.
Preventing disorders
Prevention of ankle arthritis includes:
- wear comfortable shoes;
- Timely treatment of musculoskeletal diseases;
- reasonable health control;
- control body weight;
- avoid injury;
- load control.
Prevention can reduce the risk of ankle arthritis by 2-3 times. The likelihood of a pathological process will be minimal.