There are many forms of inflammatory arthritis that can affect the body. Sometimes these will manifest initially in the feet and clinical suspicion will lead to us referring you for bloods tests with your GP or for further tests with a consultant rheumatologist. Some of these inflammatory conditions include; Rheumatoid arthritis, Gout, pseudogout, Sero negative arthritis, ankylosis spondylitis or psoriatic arthritis.
Anatomy
Inflammatory conditions tend to start off in hands and feet in the joints or at attachments of tendons, known as enthesis. Primarily the Achilles in the foot being the most common enthesis for conditions to target. Often it will affect both sides, whereas hurting your Achilles from running or exercise will often be just one sided.
Bilateral plantar fasciitis can also be an indicator that there is an inflammatory issue going on within the body, however, having bilateral plantar fasciitis does NOT always mean its an inflammatory arthritis.
Gout commonly affect the big toe joint or the ankle while psoriatic arthritis will commonly present in the 2nd or 3rd toes as swelling, nicknamed ”Sausage toe” for the fact your toe becomes very swollen and looks like a sausage.
What causes Inflammatory arthritis
In simple terms, your body starts to attack itself by causing inflammation at joints and tendons. It often comes in waves known as “Flares” and they can be very difficult to diagnose. Most have no obvious cause, they just happen but sometimes stress can trigger it.
Diagnosis
Clinical suspicion along with imaging via X-Ray, ultrasound or MRI and blood tests are all used to try and confirm an inflammatory arthritis. If you symptoms lead us to a clinical suspicion of an inflammatory arthritis during your assessment, we may perform an ultrasound scan to look at the area. If inflammation is seen, we will write a letter to your GP to request blood tests and further investigation or we can arrange onward referral to a consultant rheumatologist for further investigation.
Differential diagnosis
Tendonitis
Inflammatory arthritis Treatment
Medication is the normal management method for these conditions along with a healthy lifestyle and keeping active. During flare ups, steroid injections can be used to help reduce the pain and control a flare up of pain. At Happy Feet NI, we can perform ultrasound guided steroid injections to help with the pain if it is recommended. We would typically want a referral from your consultant or to speak to your consultant prior to providing this so as not to interact with any treatments you may be on, so please contact us prior to booking for this to discuss further or have a referral letter from your consultant rheumatologist at your appointment.