Rheumatoid arthritis is a relatively common condition affecting joints throughout the body. While rheumatoid commonly affects middle-aged women, it can appear in anyone at any age and typically runs in families.
When people talk about arthritis, they are usually referring to osteoarthritis, or simple wear and tear of the joint
cartilage. Rheumatoid arthritis is very different, caused by disease in the soft
tissues around the joint, in particular the synovium. The synovium or
synovial lining is a special membrane around many of the joints in the
body that secretes lubricating fluid between and around the bones. In rheumatoid, this lining
becomes inflamed resulting in pain, warmth and swelling. Severe
rheumatoid can lead to gradual dislocation of the joints and deformity.
Rheumatoid arthritis can affect virtually any joint in the body but tends to occur in patterns, generally affecting the MCP and PIP (the knuckles) in the hand and the corresponding MTP joints in the feet. Specific deformities seen in the feet with rheumatoid arthritis include:
- Bunion or Hallux valgus
- Partial dislocation ('subluxation') through to complete dislocation of the toes
- Heel may be twisted outwards ('hindfoot eversion')
Many people get good control of their pain through simple over-the-counter medications, however rheumatoid is a chronic disease that will probably require expert help sooner or later. Specialists that treat rheumatoid and its related conditions are called rheumatologists, however when deformity or pain is severe and not responsive to medications, orthopaedic surgeons may be asked to help.
Orthopaedic surgeons can help to treat:
- Deformity associated with rheumatoid arthritis
- Correcting deformities associated can also make footwear more comfortable and reduce the risk of ulcers and skin breakdown where the shoes rub the foot.
- Stabilisation of the ankle or foot.