Ankle Arthritis
The ankle is a complex joint formed by three bones:
- The tibia (shinbone)
- The fibula (smaller bone alongside the tibia)
- The talus (bone in the foot that sits beneath the tibia and fibula)
The ends of these bones are covered with smooth cartilage that allows them to glide against one another during movement. The joint is surrounded by a capsule lined with synovial tissue, which produces fluid to lubricate the joint.
Ankle arthritis happens when the smooth cartilage covering the ends of the ankle bones becomes damaged or deteriorates from wear and tear. When cartilage is damaged or deteriorates, the bones can begin to rub against one another, leading to pain, stiffness, inflammation, and reduced mobility.
The ankle joint is responsible for supporting the body’s weight while walking, running, climbing stairs, and performing everyday activities. As arthritis progresses, even simple movements can become uncomfortable and difficult. Understanding the symptoms and causes of ankle arthritis can help patients recognize when it may be time to seek an evaluation.
Several forms of arthritis can affect the ankle.
Post-traumatic arthritis
Post-traumatic arthritis is the most common type of ankle arthritis. It develops after an injury damages the joint. Even when an ankle fracture or severe sprain heals properly, the injury may alter the joint surface or mechanics, leading to cartilage breakdown over time. However, symptoms may not appear until years after the original injury.
Osteoarthritis
Osteoarthritis is a degenerative condition that develops when cartilage gradually wears down. While osteoarthritis commonly affects the hips and knees, it can also occur in the ankle, particularly in older adults.
Rheumatoid arthritis
Rheumatoid arthritis is an autoimmune disease in which the body’s immune system mistakenly attacks the lining of the joints. This causes chronic inflammation that can damage cartilage, bone, and surrounding tissues. Rheumatoid arthritis often affects multiple joints throughout the body and may involve both ankles at the same time.
Pain is usually the most common complaint. Early in the condition, discomfort may occur only during exercise, prolonged standing, or walking long distances. As arthritis progresses, pain may occur during everyday activities or even while resting.
Common symptoms include:
- Pain in the ankle joint
- Stiffness, especially in the morning
- Swelling around the ankle
- Tenderness when touching the joint
- Reduced range of motion
- Difficulty walking
- Pain when climbing stairs or walking on uneven ground
- A feeling of instability or weakness
- Grinding, clicking, or popping sensations during movement
Many patients notice that symptoms worsen after periods of activity and improve somewhat with rest. Others experience stiffness after sitting for extended periods and discomfort when first getting up.
As arthritis advances, ankle motion may become increasingly limited. Patients may find it difficult to squat, walk uphill, or participate in recreational activities they once enjoyed.
Prior trauma is one of the leading causes of ankle arthritis. Injuries that increase the risk of arthritis include:
- Ankle fractures
- Severe ankle sprains
- Ligament injuries
- Joint dislocations
Other factors include aging because cartilage naturally becomes less resilient and may lose some of its ability to withstand stress. This can contribute to degenerative changes within the ankle joint. Some individuals may have a genetic predisposition that increases their likelihood of developing certain forms of arthritis.
Diagnosing ankle arthritis begins with a thorough medical history and physical examination. Imaging studies can reveal joint changes.
During the evaluation, your orthopedic specialist will ask about symptoms, previous injuries, activity limitations, and how long the discomfort has been present. A history of ankle fractures, severe sprains, or inflammatory arthritis can provide important clues.
The physical examination typically includes an assessment of:
- Swelling around the ankle
- Areas of tenderness
- Joint alignment
- Walking pattern
- Range of motion
- Joint stability
- Strength of the surrounding muscles
The physician may gently move the ankle to determine whether motion reproduces pain or reveals stiffness and crepitus, which is a grinding sensation caused by rough joint surfaces.
X-rays are often the first imaging study used to evaluate ankle arthritis. They can reveal characteristic signs of joint degeneration, including:
- Narrowing of the joint space
- Bone spurs
- Changes in bone shape
- Areas of bone thickening
- Joint deformity
In some cases, advanced imaging may be recommended.
Computed tomography (CT) scans provide detailed views of the bones and can help evaluate complex arthritis patterns or prior fractures. Magnetic resonance imaging (MRI) may be used to assess cartilage, ligaments, tendons, and other soft tissues surrounding the joint.
If an inflammatory condition such as rheumatoid arthritis is suspected, blood tests may be ordered to look for markers of autoimmune disease and inflammation.
Ankle arthritis is a common source of chronic ankle pain, stiffness, and loss of mobility. The condition develops when the cartilage that cushions the ankle joint becomes damaged or wears away, leading to inflammation and joint degeneration.
Previous ankle injuries are a particularly common cause, although aging, autoimmune disease, joint misalignment, and repetitive stress can also contribute. A comprehensive evaluation by an orthopedic specialist will accurately diagnose ankle arthritis and determine the extent of joint damage. If your ankle hurts, contact Orthopedic Associates of Northern California in Chico, California to schedule a consultation.
