Abstract

Arthritis of the midtarsal joints is a common condition. The midtarsal joints are susceptible to the development of arthritis from various conditions that can damage the joint cartilage. Osteoarthritis is the most common form of arthritis that results in midtarsal joint pain; rheumatoid arthritis and posttraumatic arthritis are also frequent causes of midtarsal pain. Less common causes include the collagen vascular diseases, infection, and Lyme disease. Acute infectious arthritis is usually accompanied by significant systemic symptoms, including fever and malaise, and should be easily recognized; it is treated with culture and antibiotics rather than injection therapy. Charcot midtarsal joints may occur from a variety of peripheral neuropathies. Collagen vascular disease generally manifests as polyarthropathy rather than as monarthropathy limited to the midtarsal joint, although midtarsal pain secondary to collagen vascular disease responds exceedingly well to the treatment modalities described here.

Most patients present with pain localized to the dorsum of the foot. Activity, especially that involving inversion and adduction of the midtarsal joint, worsens the pain, whereas rest and heat provide some relief.