Inflammation toe joint
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Many forms of arthritis affect the toes.
The most common form of arthritis is osteoarthritis. While this is primarily a degenerative process, localized inflammation may also occur in the toes, particularly the base of the big toe. Osteoarthritis involvement at this location is commonly accompanied by bursitis as well. The combination is referred to as a bunion. A similar process may occur at the fifth toe. This called a bunionette.
Psoriatic arthritis and Reiter’s disease cause diffuse inflammation of toe joints and tendondons. This causes the toe to swell and resemble a sausage. The medical term is “dactylitis.”
Gout and pseudogout, which are forms of arthritis that are caused by crystals of monosodium urate and calcium pyrophosphate, respectively, may cause inflammation of toe joints, most commonly the great toe.
Sometimes inflammation of the toe may be due to localized tendonitis or bursitis as well.
Diagnosis is made clinically. In situations where the diagnosis is unclear, imaging procedures such as x-rays, ultrasound, and magnetic resonance imaging may be helpful. Treatment involves oral anti-inflammatory medications, disease-modifying drugs, and intra-articular steroid injections.
Special padding and orthotics may be helpful.
With great toe osteoarthritis, occasionally using a small needle to remove spurs under ultrasound guidance and local anesthesia, followed by injection of platelet-rich plasma canbe an excellent treatment and help a patient avoid surgery.
Sometimes surgery is required.
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