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The Human Ankle ” Part Two

The arch of the foot is also partly maintained by a strong ligament under the foot called the spring ligament, connecting the navicular with the calcaneus. It holds the arch together by resisting the tendency for the bones to separate under vertical stresses, becoming tighter the more weight is placed upon it. Due to its great strength the spring ligament is particularly useful when we are doing very vigorous movements such as running or jumping which might otherwise be too much for the muscle to resist the splaying of the arch. The muscles work more continuously at a lower level but between them and the spring ligament the talus is maintained at the top of the arch of the foot.

Reactive Arthritis

Reiter’s syndrome is another name for reactive arthritis, although the latter is being used more commonly now. Genitourinary infections with organisms such as Chlamydia and gastrointestinal infections such as with Salmonella are known to be associated with the incidence of this condition. HLAB27, a human leucocyte antigen, which is well known to be associated with the condition ankylosing spondylitis, is also connected with reactive arthritis and places it with AS in the conditions called seronegative spondyloarthropathies. Urethritis and conjunctivitis are common findings in these conditions but the arthritis can occur without them.

The Management Of Joint Pain

Joint pain can be caused by many different processes which include degeneration of the articular cartilage, infection, inflammation, trauma and deposition of crystals. Distinguishing one type of joint diagnosis from another is mostly made by taking a history and examining the joint, as this process is able to narrow down the options well. Once a provisional diagnosis is made then investigations are typically used to confirm the diagnosis and are less useful in trying to look for a cause without a narrow range of options. Clinicians try first to establish the source of the joint symptoms and then the potential underlying pathological process.