II. Imaging
- Plain Radiographs (AP, Lateral and Oblique): Preferred first-line test
- See Joint Imaging in Rheumatoid Arthritis
- See Joint Imaging in Osteoarthritis
III. Findings: Degenerative Arthritis (Osteoarthritis)
- First MTP joint commonly involved
- Associated with Hallux Valgus deformity
- Associated with Hallux Rigidus
- Rarely involves tarsal bones or ankle
IV. Findings: Rheumatoid Arthritis
- MTP joints commonly involved
- Bilateral ankles may be involved
V. Findings: Psoriatic Arthritis
- Foot commonly involved
- Sausage shaped toes may occur
- Classic psoriatic Plaque and Nail Pitting (60-80%)
- Ankle synovitis may be present
VI. Findings: Reiter's Syndrome
- Foot commonly involved
- Sausage shaped toes may occur
VII. Findings: Gout
- First MTP joint commonly involved (Podagra)
VIII. Findings: Pseudogout
- Occasionally involves Ankle Joint
IX. Differential Diagnosis: Other common conditions of the foot
-
Morton's Neuroma (commonly seen in runners and joggers)
- Paresthesias at second and third MTP joint web space
- Pain reproduced on palpation
-
Plantar Fasciitis
- Heel Pain worse at first steps in the morning
-
Achilles Tendonitis
- Also seen in patients with Spondyloarthropathy