ankle arthritis

Ankle arthropathy is a degenerative dystrophic disease of the structures of the musculoskeletal system. Affects lower limbs. It is considered one of the most common forms of arthropathy: accounting for 30% of the total cases of degenerative dystrophic joint damage. This pathological process occurs not only in elderly patients. About a quarter of the patients are people under 40 years old.The disease is associated with persistent pain and progressive decline in joint and lower limb function. If left untreated, it will progress and will not go away on its own. Diagnosis and treatment of the disease are the responsibility of orthopedic surgeons (including traumatologists, physical therapists, and physical therapists, depending on the cause).

Causes of ankle arthritis

Osteoarthritis is considered a multi-causal disease. Its development is the result of a series of factors. With age, the number of disease-causing factors increases, and therefore the likelihood of pathological processes increases. But not everything is that simple.

The pathogenesis of the disease

Ankle arthritis has several causes, the most common of which are:

• Unreasonable physical activity;
• Injuried;
• operations;
• Metabolic diseases;
• shoes are uncomfortable;
• Other diseases of the musculoskeletal system;
• Rheumatoid disease.

Irrational stress can be a result of lifestyle or career choices. Continuous walking, standing in one place, carrying heavy objects, strenuous activities. All these are provocateurs of pathological processes in the medium term (a few years).Another cause is injury, especially intra-articular fractures, dislocations, and, to a lesser extent, severe bruising. Arthropathy of the ankle often goes unnoticed but can progress. Patients often underestimate the consequences of the trauma they have experienced.Surgery may cause joint disease. However, this complication is relatively rare. Mainly due to incorrect assessment of the clinical situation. Doctors are not qualified enough.Metabolic pathologies, such as diabetes, can cause disease. More commonly, however, the causes of ankle arthritis are gout and hormonal imbalances (for example, menopause).Uncomfortable shoes are one of the key factors in the development of pathological processes. This disease occurs due to improper load distribution in the foot. Often complex diseases occur: not only joints, but also spinal injuries. At least - osteochondrosis. But more dangerous problems are also possible.Dysfunction of the musculoskeletal system itself also increases the likelihood of pathological processes. Intervertebral hernias, osteochondrosis, and congenital disorders pose additional risks.Rheumatoid diseases are represented 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. Generally speaking, it develops simultaneously under the influence of multiple reasons. There are exceptions, but they are 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 gradual. In the initial phase, local blood circulation and the distribution of dynamic loads in the foot are disturbed. Gradually, destructive processes in the cartilage are added. Slow inflammation begins. Degeneration also occurs in other structures of the ankle joint: joint capsule, ligaments, bones, etc. The more severe the condition, the more difficult it is to treat. This requires more effort and time.

Factors that increase the risk of joint disease

The dystrophic destruction of ankle tissue is not only the result of the influence of direct causes. The severity, likelihood and nature of the disease's course are influenced by risk factors. They complete the full picture of the violation. Among them:

• the habit of wearing high heels;
• the physical difficulty of the job (including occupations with less obvious risks: teachers, cooks can also get sick);
• Previous ankle injury (in some cases, the condition develops years after the injury);
• History of endocrine disease (hormone imbalance poses additional risks);
• History of musculoskeletal disorders;
• Over 40 years of age (although the disease also occurs in younger people);
• weight gain;
• Gender (women are more likely to suffer than men).

Arthritis of the ankle is a slowly developing disease; symptoms may not appear immediately. Therefore, it is difficult to assess which risk factors and causes trigger the pathological process. It is necessary to collect a complete medical history.

Classification and Types of Ankle Injuries

Pathologies are classified on two bases.The first criterion is the origin of the pathological process. emphasize:

• Post-traumatic forms of the disease (occurring after injury to the ankle joint or other structures of the musculoskeletal system);
• Deformed ankle joint: the result of metabolic disorder or injury, with slow but steady joint deformation;
• Metabolic arthropathy occurs in the context of diabetes, hormonal disorders, or gout (a disorder of purine metabolism).

The second basis for classification is the staging of the pathological process. During its development, the joints of the ankle go through the following stages:

• original or early;
• progress;
• Advanced joints.

In the first stage, there are no such clinical symptoms or they appear after strenuous physical activity. Pathological processes can only be detected with the help of special diagnostic methods.Progressive stages of the disease are accompanied by clinical intensification. Symptoms appear after light physical activity. Load tolerance is reduced. There is a persistent pain syndrome, as well as limited ankle and leg movement.The final stage of the pathological process is accompanied by severe pain and other symptoms in a state of complete rest. Supportive and motor functions are impaired. A person often becomes disabled. Complex surgical treatment, including endoprosthesis, is required.

important!Staging plays the greatest role in determining treatment strategies and predicting the course and outcome of the disease. This disease is best treated in its early stages. The more advanced the pathology becomes, the more difficult and time-consuming correction becomes.

Symptoms of the disease

Clinical manifestations depend on the form and stage of the pathological process. Typical manifestations include:

• pain;
• fatigue;
• exercise intolerance;
• swelling;
• Leg support dysfunction;
• Muscle weakness.

Leg pain is initially observed only after strenuous physical activity. Then a little activity is enough. In the advanced stages of the pathological process, pain is always present regardless of the load.Fatigue can be observed from the first stages of the disease. Feelings of muscle weakness and fatigue worsen as the disease progresses. Signs indicate further progression of the disease.Exercise tolerance also gradually decreased. In the obvious stages of the disease, patients are unable to climb to the second or third floors. We must stop.Swelling is an always-present sign. The legs look swollen and thick at the ankles. This is a non-specific manifestation.It is typical to have pain at first. After staying in one place for a long time, severe stiffness can develop in the joints. The first move can cause a lot of discomfort. As the patient continues to move, the pain and discomfort will gradually subside.Clinical manifestations depend on the degree of arthritis in the ankle joint. Plays an important role in determining the stage and severity of pathological processes. Doctors systematize symptoms through a process of verbal questioning and history taking.The disease is characterized by a chronic course. Signs of arthropathy are most evident in the ankle joint during exacerbations. In the chronic phase, relief is only partial. The clinic is less bright, but the symptoms haven't completely gone away. Then there was a new exacerbation of the arthrosis of the ankle joint, and the manifestations again became intense. This cycle repeats until high-quality processing is achieved.

Complications of ankle arthritis

Complications of pathological processes are related to the ability to maintain the ability to work and take care of oneself.Patients will develop ankle deformity. The pathological process ends with the formation of contractures, areas of major or complete immobility of the ankle limb. This condition can only be corrected with surgery.In exacerbations, the development of synovitis and bursal inflammation is typical. This condition lasts for several weeks, and in the acute course there is a complete loss of the ability to work and carry out activities.The end result of the pathological process is a decrease and then complete loss of the leg support function; the person is unable to move normally. You have to use crutches. Complete loss of the ability to work and, in some cases, even the ability to take care of oneself. In advanced stages of the ankle joint, patients become disabled.

Diagnosis of disease

Diagnosis of injuries to joint structures and cartilage tissue is performed under the supervision of an orthopedic traumatologist. The exam is typical. It is not difficult to identify the pathological process and its severity. Among the technologies:

• Interview patients verbally to better understand the nature of symptoms and health complaints;
• Collect a medical history that will allow you to determine the possible origin of the pathological condition;
• Palpation: joint deformation, swelling, pain during passive movement;
• Ankle radiography: A routine examination that provides enough information to make a diagnosis and determine its severity and is considered the gold standard examination;
• If radiographic data were insufficient, MRI was performed.

Additional studies can be conducted. For example, computed tomography (arthrosis affects not only cartilage but also bone; CT can show the nature of the disease in detail and accurately).

notes!Arthropathy has no specific manifestations, especially in its early stages. Therefore, without sufficient knowledge, you yourself will not be able to distinguish pathological processes. Special instrumentation is required for diagnosis.

Laboratory diagnostic techniques provide little data. They are informative only in identifying inflammatory processes and help in the diagnosis of certain forms of arthropathy (metabolic origin, rheumatoid nature).

treatment method

Treatment of ankle arthritis is performed using conservative and surgical techniques. Best results are obtained if complex corrections are used.Conservative treatments include the use of medications, exercise therapy, and massage physiotherapy. Use the following medicines:

• Topical anti-inflammatory;
• General anti-inflammatory drugs (in tablet or injection form);
• chondroprotectant;
• Niacin and other ways to improve metabolic processes.

Exercise and physical therapy as well as massage are aimed at recovery after the acute condition has resolved. These methods are important during remission. If the disease occurs in an acute form with clear clinical symptoms, this approach is postponed.Deformities and persistent deviations of joint anatomy require surgical treatment. Arthroplasty or endoprosthesis, joint replacement with artificial analogues is possible. This is a high-tech correction method.

predict

The prognosis depends on the length of treatment, your health, the cause of the joint disease, and the extent of the disease. The more severe the condition, the more complex the situation. If treatment is started early, prospects for cure and full recovery are good. In other cases, surgery and long-term recovery are required.

disease prevention

Ankle prevention includes:

• Wear comfortable shoes;
• Prompt treatment of musculoskeletal disorders;
• reasonable control of welfare;
• weight control;
• avoid injury;
• load control.

Prevention can reduce the risk of ankle joints by 2-3 times. A pathological process is highly unlikely.