To diagnose big toe arthritis, your doctor will examine your foot for range of motion and gait analysis. X-ray evaluation is important to determine the amount of joint narrowing and bone spur formation in the joint.
Arthritis Diagnosis
Doctors diagnose arthritis with a medical history and physical exam to check for joint inflammation and deformity. Your doctor may also order lab work like blood, urine and joint fluid tests. X-rays are commonly used to check for cartilage loss in the affected joints, narrowing of the space between bones and the existence of nodules. Following the initial diagnosis, x-rays are also used to mark your arthritis progression.
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Dr. Christopher W. Hodgkins, MD , Orthopedic Surgery, answered on behalf of Baptist Health South Florida -
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Dr. Thomas P. San Giovanni, MD , Orthopedic Surgery, answered on behalf of Baptist Health South FloridaIn the foot, arthritis most frequently occurs in the big toe, although it is also often found in the midfoot and ankle. A doctor can usually diagnose arthritis based on symptoms and standard x-rays. -
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Dr. Grant Cooper, MD , Physical Medicine & Rehabilitation, answered
The presence of asymptomatic findings of arthritis on an X-ray should be taken as a warning that the joint is not healthy and will probably become painful if you don't start taking better care of it.
A person with no clinical symptoms and X-ray findings of arthritis should be treated in the same way as someone with no symptoms and no X-ray findings. Both should eat right, exercise, and take the appropriate supplements. The key difference is that the person with X-ray findings may be at greater risk of developing symptoms sooner, and should take preventative measures as soon as possible. Routine screening with X-rays to look for arthritis damage is definitely not indicated because they expose the patient to unnecessary radiation and are costly.
Noticing signs of arthritis on X-ray should prompt a greater sense of urgency for the patient to take steps to reduce the risk of developing worsening arthritis, which likely will eventually lead to pain and suffering if it is not appropriately managed. -
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Dr. Grant Cooper, MD , Physical Medicine & Rehabilitation, answered
The degree of severity of arthritis on an X-ray often does not correlate with symptoms. A person with a terrible looking X-ray of the knee may be completely symptom-free. Likewise, a person who shows minimal arthritis on an X-ray may be experiencing severe pain. This does not mean that one person is stoic and the other is a complainer. Different people have higher or lower thresholds for pain, depending on their body biochemistry and the synapses within their brain. Many factors influence the pain threshold in a given individual, including social support, depression, painful stimuli, and other potential biochemical and neuromodulating factors.
Someone who has severe cartilage degeneration may not have reached the point where the surrounding structures have become irritated and inflamed. If only cartilage is involved, there will be no pain because cartilage doesn't have any nerve endings. By contrast, the person with minimal X-ray findings of cartilage degeneration may just be unlucky enough to have the cartilage degrade in a pattern that allows pressure to be placed on the surrounding structures, leading to irritation and inflammation. Perhaps the synovium was already inflamed, or perhaps the bone was already compensating for increased pressure, and a tiny bone spur hooked a piece of the joint capsule or irritated a ligament. -
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Dr. Grant Cooper, MD , Physical Medicine & Rehabilitation, answered
In addition to X-rays, CT scans, and/or MRIs, your doctor might order blood tests to help rule out infection, types of arthritis other than osteoarthritis, cancer, and other problems. Most people with straightforward signs and symptoms of arthritis may not require more than an X-ray. However, your physician will make that determination in order to help ensure that a more serious underlying disorder does not go undiagnosed and untreated.
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Dr. Grant Cooper, MD , Physical Medicine & Rehabilitation, answered
X-rays are more than sufficient for diagnosing arthritis. They can show bone spurs (osteophytes), subchondral cysts (the fluid-filled cysts that sometimes occur beneath the hardened bone), and joint space narrowing (the most classic finding in arthritis of the knee). As the cartilage degenerates, the bones move closer and closer together until they actually grind into each other. X-rays can mark this progression, although hopefully measures will be taken to slow or halt the progression once it is identified.
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See All 2 AnswersArthritis can be diagnosed with a simple physical exam and review of your medical history. If any questions remain, lab work and imaging may be indicated. -
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Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answeredAn x-ray can show the damage done to the bones of the joint due to loss of protective cartilage and bones rubbing directly against each other.
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Dr. Thomas P. San Giovanni, MD , Orthopedic Surgery, answered on behalf of Baptist Health South FloridaTo diagnose hindfoot arthritis, the doctor will examine your foot and may ask you to walk so he or she can observe your gait. X-rays will help reveal any degenerative changes. Additional tests such as MRI may also be called for to help determine any other abnormalities or sources of pain.
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Dr. Christopher W. Hodgkins, MD , Orthopedic Surgery, answered on behalf of Baptist Health South FloridaIn order to diagnose arthritis of the midfoot, the doctor will examine your foot and may order imaging studies. Weight-bearing x-rays can demonstrate loss of joint space in the midfoot joints, which is characteristic of arthritis.