Diagnosing Foot & Ankle Arthritis

Arthritis refers to inflammation in the joints that results in joint damage. There are many types of arthritis that develop for different reasons, but nearly all cause pain and stiffness in the affected joints, which can limit movement. Arthritis can involve physical changes in the tissues that make up a joint, including cartilage, muscles, tendons, ligaments, and bones. For example, if the smooth material that lines and protects the joints and cushions the bones, called cartilage, is damaged, the bones may rub directly against one another. This increased friction may cause hard growths called osteophytes or bone spurs to develop, causing increased pain and interfering with joint movement.

Arthritis may affect one or more of the 33 joints in the foot and ankle. These joints allow the foot and ankle to be flexible and to absorb the weight of the body during movement. People with foot or ankle arthritis may experience pain and discomfort when standing, walking, participating in sports, or performing other physical activities.

Foot and ankle arthritis pain often follows a recognizable pattern. People tend to feel aching pain and stiffness after a period of inactivity, as when getting up in the morning or rising from a chair after sitting for an hour or more. Walking and other everyday movements may help relieve this “start-up” discomfort, but arthritis pain usually returns after prolonged activity.

Doctors at NYU Langone Orthopedic Hospital and the Center for Ankle Arthritis specialize in helping people with foot and ankle arthritis manage symptoms and remain active. Our orthopedic and rheumatology experts work together to ensure that you receive an accurate diagnosis, as well as customized care that meets your needs.

Medical History

NYU Langone doctors obtain a thorough medical history as part of every diagnosis of foot and ankle arthritis. Doctors ask you for details about when you first noticed symptoms, what part of the foot is most affected, whether one or both feet are involved, when pain and stiffness are most noticeable, and whether the symptoms affect the quality of your life.

Information about your broader medical history may help doctors confirm a diagnosis of arthritis and determine the type. For example, if you’ve had previous foot or ankle sprains or fractures, or if you have had surgery on your foot or ankle, this may indicate that post-traumatic arthritis is causing symptoms. If osteoarthritis has been diagnosed in other joints in the body, it may also be the cause of your foot and ankle symptoms. If you have undiagnosed aches and pains in different parts of your body, and if you also experience swelling or a feeling of warmth along with the discomfort in your foot or ankle, rheumatoid arthritis may be the cause.

Physical Exam

In addition to asking about symptoms and your medical history, your doctor examines your foot and ankle to check for signs of arthritis in the joints. These may include swelling and tenderness, a cracking or popping sound during movement, or physical changes in the shape of your foot such as bunions or hammertoe.

Your doctor may ask you to stand and walk to evaluate how movement affects the joints in your foot and ankle. If the foot doesn’t align properly with the rest of your body—for example, if your foot points sideways instead of straight ahead—it may indicate arthritis. Doctors also assess whether your symptoms limit the range of motion in your foot or ankle by asking you to point, flex, and rotate your foot.

X-ray

To confirm a diagnosis of arthritis and determine the extent of the condition, doctors may recommend an X-ray of your foot and ankle. X-rays create pictures of the bones of the foot and ankle that doctors analyze for any visible changes in the spacing of the joints. Reduced joint space may indicate the erosion of cartilage. X-rays may also reveal small bone spurs, known as osteophytes, that can develop on the bones of the joint and impair how the joint functions.