Rheumatoid Ankle

Rheumatoid arthritis is an autoimmune disease of the synovial lining of joints. Typically, the joints affected are those in the extremities fingers, wrists, toes, and ankles. It is a debilitating disease in which ligaments may be damaged and joints deformed. 

Arthritis Arthritis is the general term for chronic pain in the joints the fingers, wrists, elbows, shoulders, knees, ankles, and feet. There are two types of arthritis— rheumatoid arthritis, which results from an inflammation of the thin membranes that line the joints, and the more common osteoarthritis, which results from a... 

The joints affected most frequently by rheumatoid arthritis are the small joints of the hands, wrists, and feet (Fig. 89-3). In addition, elbows, shoulders, hips, knees, and ankles may be involved. Patients usually experience joint stiffness that typically is worse in the morning. The duration of stiffness tends to be correlated directly with disease activity, usually exceeds 30 minutes, and may persist all day. Chronic inflammation with lack of an adequate exercise program results in loss of range of motion, atrophy of muscles, weakness, and deformity. 

Michelson JM, Easley, et al. Posterior tibial tendon dysfunction in rheumatoid arthritis. Foot Ankle Int 1995 16(3) 156-61. 

Wakefield RJ, Gibbon WW, Conaghan PG et al (2000) The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis a comparison with conventional radiography. Arthritis Rheum 43 2762-2770 Wang CL, Shieh JY, Wang TG et al (1999) Sonographic detection of occult fractures in the foot and ankle. J Clin Ultrasound 27 421-425... 

Peroneal tendon tears can be observed in patients following ankle sprains or with a history of chronic instability, especially if they are affected by systemic disorders such as rheumatoid arthritis and diabetes mellitus or are receiving corticosteroids (Kraus and Brodsky 1998 Wang et al. 2005). Clinically, the rupture of peroneal tendons leads to inability to evert and cavovar us foot Tears of the peroneus brevis tendon are most common and present with a typical longitudinal configuration, commonly referred to as split or fis-... 

The tibialis posterior tendon is the most commonly injured tendon on the medial side of the ankle. Its rupture is typically encountered in middle-aged obese women or as a result of systemic disease, such as rheumatoid arthritis or seronegative spondyloarthropathy (Johnson 1983). Acute fractures of the ankle may also be responsible for some cases of rupture of this tendon. In most cases, tibialis posterior tendon tears occur around the medial malleolus, but they may also be encountered at the navicular insertion. Rupture of the is frequently overlooked clinically because it often develop with no history of trauma. Initially, the patient complains of pain and swelling around the affected tendon. Then, as the severity of the lesion gradually progresses toward rupture elongation, gradual collapse... 

Chronic posterior ankle pain may also be related to bursal pathology, which may occur as an isolated disorder but is more often secondary to inflammatory disorders, such as rheumatoid arthritis and seronegative spondyloarthropathies, or repetitive trauma, usu-... 

Brock JG, Meredith HC (1979) Case report 102. Osteomyelitis of hallux sesamoid. Skeletal Radiol 4 236-239 Brook A, Corbet M (1977) Radiographic changes in early rheumatoid arthritis. Ann Rheum Dis 36 71-73 Bruce WD, Christofersen MR, Phillips DL (1999) Stenosing tenosynovitis and impingement of the peroneal tendons associated with hypertrophy of the peroneal tubercle. Foot Ankle Int 20 464-467... 

Kaukonen IP, Raunio P. Total ankle replacement in rheumatoid arthritis a preliminary review of 28 arthroplasties in 24 patients. Ann Chir Gynaecol 1983 72(4) 196-9. 

Lachiewicz PF, IngUs AE, Ranawat CS. Total ankle replacement in rheumatoid arthritis. 7 Bone Joint Surg Am 1984 March 66(3) 340-3. 

Unger III AS, Inglis AE, Mow CS, Figgie HE. Total ankle arthroplasty in rheumatoid arthritis a long-term follow-up study. Foot Ankle 1988 Febmary 8(4) 173-9. 

Kirkup J. Rheumatoid arthritis and ankle surgery. Ann Rheum Dis 1990 October 49(Suppl. 2) 837 4. 

Nagashima M, Takahashi H, Kakumoto S, Miyamoto Y, Yoshino S. Total ankle arthroplasty for deformity of the foot in patients with rheumatoid arthritis using the TNK ankle system clinical results of 21 cases. Mod Rheumatol 2004 14(l) 48-53. 

Carlsson A, Markusson P, Sundberg M. Radiostereometric analysis of the double-coated STAR total ankle prosthesis a 3-5 year followup of 5 cases with rheumatoid arthritis and 5 cases with osteoarthrosis. Acta Orthop 2005 August 76(4) 573-9. 

Su EP, Kahn B, Figgie MP. Total ankle replacement in patients with rheumatoid arthritis. Clin Orthop Relat Res 2004 July(424) 32-8. 

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