A health professional must eliminate other all likely causes of ankle pain before making a diagnosis of ankle arthritis. Physicians use a comprehensive approach that is verified by diagnostic imaging to arrive at a clinical diagnosis.

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Below is a description of the process physicians use to determine if a patient’s symptoms are caused by ankle osteoarthritis.


Patient Interview

A doctor will ask a patient about family history and to describe the onset of his or her symptoms, the pattern of pain and swelling and how symptoms affect lifestyle, as well as what makes the pain better or worse. A patient’s reported symptoms are important for diagnosis and treatment.

Physical Exam

A doctor will physically examine the patient’s ankle, noting any signs of swelling, pain points, stiffness, and range of motion. A doctor may also ask a patient to pace across the room to evaluate gait.

Testing for Ankle Osteoarthritis

A doctor is often able to judge whether a person’s symptoms are caused by ankle osteoarthritis or not after the patient interview and physical exam. Medical imaging, such as x-rays, and lab tests may be ordered to gain further information about the extent of the arthritis and/or rule out other possible causes of the ankle pain.

A loss of joint space between the tibia and fibula and the talus bone, which indicates a loss of cartilage in the ankle, can be seen on an x-ray. An x-ray can also show bone spurs, a sign that the bones have tried to compensate for cartilage loss with extra bone growth.

Magnetic Resonance Imaging (MRI)
More sensitive than an x-ray, an MRI provides images of the soft tissue (ligaments, tendons and muscle) as well as the bone.

This more detailed image of the ankle joint can be helpful if x-rays of the ankle are inconclusive or if the doctor suspects symptoms are due to something other than osteoarthritis, such as damage to the ankle’s tendons or ligaments. However, an MRI is more time consuming—requiring the patient to remain perfectly still for about 30 minutes—and is more expensive than an x-ray.


Lab tests
Ankle osteoarthritis cannot be detected with lab tests, but lab tests can help rule out other problems, such as rheumatoid arthritis or gout, which can also cause ankle pain. Lab tests may require a drawing fluid from the ankle or blood from the arm of the patient.

A doctor will diagnose ankle arthritis after ruling out other possible diagnoses. About 1% of the population has ankle osteoarthritis. 1 Cushnaghan J. & Dieppe P. Study of 500 patients with limb joint osteoarthritis. I. Analysis by age, sex, and distribution of symptomatic joint sites. Ann Rheum Dis. 50, 8–13 (1991). As cited in Nakamura Y, Uchiyama S, Kamimura M, Komatsu M, Ikegami S, Kato H. Bone alterations are associated with ankle osteoarthritis joint pain. Sci Rep. 2016;6:18717. Published 2016 Jan 18. doi:10.1038/srep18717.

Dr. Dean Sorrento is a podiatrist specializing in foot and ankle surgery at OAA Orthopedic Specialists in Allentown, PA. Dr. Sorrento has several years of experience treating osteoarthritis, trauma, and deformities.