Extra Articular Reactivities
Comments (0) Most people have heard somewhere along the line of rheumatoid arthritis (RA) or osteoarthritis. These conditions have been previously described on this blog and can cause serious pain and damage to the joints of your feet and ankles. However, there are many other arthritic disorders that can also affect the lower extremities which is why a proper podiatric work-up can help to distinguish some of these conditions. Similar to RA, there are three fairly common diseases (along with multiple others) which also demonstrate similar inheritance patterns and tend to affect similar joints. These include Ankylosing spondylitis, Psoriatic arthritis, and Reiter’s syndrome.
Ankylosing spondylitis, also called Marie-Strümpell’s disease, most often affects males. It typically begins when people are in their 30’s but often times the disease itself is not diagnosed right away because the early signs and symptoms are vague. However, these can include multiple manifestations including eye problems, stomach inflammation, and neurologic deficits. The classic finding, however, is lower back or buttock pain which tends to radiate down the thighs. In the lower extremity, symptoms can occur at the balls of the feet where degeneration and dislocation occurs at the joint. Symptoms may also arise in the heel where pain and inflammation occur at locations where tendons and bones connect.
Psoriatic arthritis, as you can imagine, is closely associated with psoriasis although there are also other genetic, environmental, and immune system-related factors. The most common presentation involves the joints of the toes and results in widening at the joint space as well as joint destruction, toe swelling, and possible knee involvement. Interestingly, this disease also presents with unique nail changes; specifically the development of many small pits in the nails which may indicate the onset of the disease.
Reiter’s syndrome is a form of reactive arthritis which occurs in response to an infection elsewhere in the body. The infection in question is usually either a urinary tract infection or a gastro-intestinal infection and thus often follows the contraction of a sexually-transmitted disease or the consumption of contaminated foods. Of course, this disease process includes many systemic signs, but in the lower extremity it exhibits symptoms similar to Psoriatic arthritis and Ankylosing spondylitis including swollen toes, nail changes, and heel pain.
If you’re experiencing the symptoms of one of these conditions, your local Chandler foot doctor can be especially helpful. For one thing, there is a wide variety of other conditions including gout, RA, osteoarthritis, and lupus among others which will need to be effectively ruled out. Most of these conditions have different radiographic patterns which is helpful in that respect. Furthermore, if one of these conditions is diagnosed, your podiatrist has a huge role to play in the conservative and/or surgical management of your symptoms. Feel free to make an appointment today with any questions.
