Ankle pain and ankle injuries are common. Physicians must carefully eliminate other conditions before making an ankle arthritis diagnosis. Physicians use a comprehensive approach that is verified by diagnostic imaging to arrive at a clinical diagnosis.

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 patient’s symptoms are caused by osteoarthritis or not after the patient consultation and physical exam. Follow-up tests are usually included as part of the diagnostic process both to gain further information about the extent of the arthritis and to rule out other possible causes of the patient’s pain.

    X-rays. X-rays are a useful tool in detecting ankle arthritis. X-rays can show if there is a loss of joint space between the tibia and fibula and the talus bone, indicating a loss of cartilage in the ankle. An x-ray can also show bone spurs, a sign that the bones have tried to compensate for cartilage loss with extra bone growth.

    MRI. Magnetic Resonance Imaging (MRI) may be ordered to provide additional detail, as this test 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. Lab tests cannot identify the presence of ankle osteoarthritis, but they can be used to rule out other problems, such as infection or gout, which can also cause ankle pain. Lab tests may require a blood draw or a needle aspiration of the ankle joint.