Ankle osteoarthritis (hind/mid-foot)
NHS Tayside RefGuide
Warning
Ankle Osteochondral Lesion
Who to refer
No improvement with conservative measures at three months and persistent pain and would consider surgical fusion.
How to refer
SCI Gateway/Orthopaedics/Foot & Ankle Service.
Referral will be vetted by an AHP and directed to the most appropriate healthcare professional.
Information to include when referring
- Duration and any cause of symptoms
- Site/spread of pain. Constant or intermittent symptoms. Disturbing sleep?
- Treatment to date (injection, orthotics, any podiatry, physiotherapy)
- BMI
- Range of movement, effect on walking and activities, any walking aid?
- X-ray results (AP and lateral standing).
General information
Can be talocrural, subtalar or midfoot.
Symptoms and signs
- Complains of swelling, catching, locking. Pain and stiffness.
- Local tenderness
- Loss of medial longitudinal arch
- Reduced ability or increased pain on moving or weight bearing.
Primary Care management
- Advise 'extra width' footwear.
- Weight loss, walking aids, analgesia, NSAIDs as appropriate.
- X-Ray AP lateral and standing views (if will alter management).