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Midfoot Arthritis

Imaging - Please include an up to date X ray with weight bearing views report within or attached to the referral.  This includes for soft tissue injuries to exclude underlying pathology.  

Referrals without up to date reports included and Xrays that are not weight bearing will be returned, unless there are mitigating circumstances why this is not possible



The midfoot refers to the bones and joints that make up the arch and connect the forefoot to the hind foot. Arthritis can be the result of previous trauma, RA, OA or tibialis posterior tendon dysfunction (causing a flattened arch).

Symptoms include pain, loss of flexibility of the foot and a swelling may become apparent on the top of the foot that can be hard and bony.


REFERRAL:

Urgent Referral:

  • Deteriorating foot shape


Routine Referral: (
Please request an xray within 6 months)

  • MARKEDLY symptomatic or RIGID flat foot
  • Significant rest or night pain  
  • Significant functional impairment *
  • MINIMALLY symptomatic and FLEXIBLE flat foot not responding to conservative treatment >6 months.

 

(If the patient can go up onto tip toe unaided and the foot is flexible when assessed on the couch, most patients will get significant relief from referral to MSK podiatry and orthotic management.)

*Significant functional impairment is defined as a restriction or interference with an individual’s capacity to meet personal, social or occupational demands.  Please state the impairment of the individual is experiencing

Surgery can involve removing any bony prominences on the top of the foot (cheilectomy) or a midfoot fusion of the small painful joints.

REFERENCES:

BOFAS Evidence Based Commissioning guidelines: https://www.boa.ac.uk/wp-content/uploads/2016/11/flatfoot-pathway-2-2.pdf

 

 

 

Date reviewed                     25/06/2019

Next review due                  25/06/2020

Sifter name                          Dr Rebecca Hopkins

 

Version No. 1.1