Rheumatoid arthritis: A widespread inflammation of the joints with a chronic course

Rheumatism is the medical collective term for various diseases of the musculoskeletal system - i.e., the muscles, tendons, joints, bones, and connective tissue. One of the most common rheumatic diseases is rheumatoid arthritis. Here, the inner skin of the joints becomes inflamed, which can cause stiffness, malposition and pain.

In this article, you will get an overview of the most important questions around the topic of rheumatoid arthritis, especially on the foot.

Do you suffer from stiff or swollen toe joints? Then it could be helpful to clarify whether a systemic disease such as rheumatoid arthritis might be the cause.

Rheumatoid arthritis is considered the most common inflammatory disease of the joints. It is an autoimmune disease in which the synovial membranes act as antigens and produce the body's own antibodies.

Rheumatoid arthritis of the foot manifests itself with chronically recurring pain, which first occurs in the small joints of the toes. It is also characteristic that the complaints occur on both sides. During this inflammatory process, the proliferating mucous membrane of the joint capsule attacks the joint cartilage. The chronic inflammations gradually restrict the function of the joints and can degenerate them completely in the long run.

 Possible causes and risk factors of rheumatoid arthritis include:

• genetic factors
• Infectious agents
• Smoking

What are the symptoms of rheumatoid arthritis of the foot?

Rheumatoid arthritis can manifest itself with the following specific symptoms:

• Joint pain especially in the small joints and symmetrically on both halves of the body
• Morning stiffness of the joints lasting longer than 30 minutes
• Movement restriction
• Rheumatoid arthritis progresses in relapses.
• In a rheumatic flare-up, all joints can suddenly be affected.
• Shrinkage of the fat pads under the metatarsal bones (in rheumatoid arthritis of the foot)

Consequences of the chronic inflammation can be malposition of the joints (outward deformation of the toe joints) or arthrosis. Furthermore, the joint surfaces and joints gradually become completely degenerated.

The foot surgeon Dr Tonio Gottlieb, MD is your specialised contact partner for everything to do with foot health and foot surgery. In his practice in Berlin-Zehlendorf, he will examine you with the utmost care, always keeping an eye on your entire body statics. Based on a comprehensive diagnosis, he will give you a stringent recommendation for action. Whether you need an initial diagnosis or a second opinion - make your personal consultation appointment now!

More about Dr Gottlieb, MD

In rheumatoid arthritis of the foot, the symptoms occur mainly in the metatarsophalangeal joints of the toes. Basically, the small joints are affected first and only in the further course of the disease the large joints.

The ankle joint is usually rarely affected by rheumatoid arthritis. This means that a swollen foot does not necessarily have to be rheumatism. More often, pain caused by swelling in the ankle joint is due to ankle joint arthrosis.

Pain in the joints of the foot and toes can have many causes. Triggers can be, for example:

1. Rheumatoid arthritis (colloquially: rheumatism)

2. arthrosis (age-related wear and tear of joints)

3. ankle joint arthrosis

If rheumatoid arthritis is suspected, the specialist (rheumatologist) will determine rheumatoid factors. For this purpose, a blood sample is taken and then the rheumatoid factor in the blood serum is measured. This is particularly elevated in rheumatoid arthritis.

At the beginning of the disease, the rheumatoid factor is positive in almost half of the patients; in the further course, 70 to 80% of those affected show elevated values. However, the rheumatoid factor is only one of several parameters that are used for the diagnosis. Other blood values that should be checked are, for example, the erythrocyte sedimentation rate, the inflammatory protein C-reactive protein (CRP) or antibodies against certain proteins (ACPA).

Imaging procedures such as X-ray, MRI or CT can also be used for further clarification. Different diagnostic procedures are available for each form of rheumatism, which the attending physician will select in each individual case.

In the case of a rheumatic disease, the specialist (rheumatologist) will inhibit the inflammation as a first step. Suitable medications to reduce inflammation and relieve pain in rheumatoid arthritis are cortisone or methotrexate.

For all secondary diseases of the musculoskeletal system, either conservative treatment methods (shoe insoles, physiotherapy, etc.) or surgical procedures are available.

If rheumatoid arthritis is suspected, Dr Tonio Gottlieb, MD will first refer you to a rheumatologist to clarify the underlying disease and, if necessary, have you treated with medication.

For all secondary diseases caused by "rheumatism" that affect the toe and foot joints, the Berlin foot surgeon Dr Tonio Gottlieb, MD offers special diagnostic procedures. These include, among other things, examination on a foot platform with integrated podoscope. With great professional knowledge and extensive experience, he develops the best possible therapy plan for his patients to alleviate the symptoms triggered by rheumatoid arthritis and to improve foot health.