Rheumatoid Arthritis Foot Deformity

Rheumatoid arthritis is an autoimmune disease, caused by the body attacking its own healthy tissue. With rheumatoid arthritis, the immune system attacks the lining or membrane of the joints, which causes pain, stiffness and swelling in the joints. Rheumatoid arthritis can affect any joint in the body and often affects the ankles and feet. When the lining of the joints within the feet become swollen and inflamed because of rheumatoid arthritis, the joints may become deformed causing physical malformations of the foot.

Symptoms of Foot Deformity

Individuals with rheumatoid arthritis in the feet are at an increased risk of developing certain physical deformities. These conditions develop as a result of joint inflammation, weakening of the ligaments and lining, and a degeneration of cartilage in the joint. The symptoms usually appear in both feet, affecting the same joints on each foot and may include:

  • Claw toe
  • Hammer toe
  • Bunions
  • Calluses
  • Metatarsalgia

Softening of the bone, or osteopenia, may also result in stress fractures and collapse of bone. These can be extremely painful and disabling conditions and patients often have difficulty walking and wearing shoes as the feet become increasingly inflamed.

Treatment of Foot Deformity

The pain and discomfort caused by rheumatoid arthritis is often treated with medication such as anti-inflammatory drugs, corticosteroids and immunosuppressants. These treatments focus on controlling pain, minimizing inflammation and slowing the progression of joint damage. Treatment for deformities of the feet varies depending on the type and severity of the condition, but is designed to restore mobility and the normal appearance and alignment of the foot. Conservative treatments may include limiting activities that worsen pain, and wearing orthotic devices, custom-made shoes, or braces. In severe cases, surgery may be recommended to correct deformities and may include:

  • Joint fusion
  • Hoffman procedure
  • Osteotomy
  • Resection

To treat claw toes, which cause toes to bend irregularly, doctors may perform surgery to cut tendons or remove a small portion of bone in the toes, to allow them to straighten. After surgery, most patients regain mobility and are often able to walk and wear regular shoes again without pain.

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