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Calcanealcuboid Joint

CALCANEAL CUBOID JOINT ARTHRITIS
By:  Robert  H. Sheinberg, D.P.M., D.A.B.F.A.S.,  F.A.C.F.A.S.

Pain on the outside of the foot just in front of the ankle may be due to injury or arthritic changes to the calcaneal cuboid joint.

CAUSES:

  • A high arch foot causes increased pressure to the calcaneal cuboid joint area.  With excessive stress to that region, bone spurs can develop in the joint.
  • Trauma to the outside of the foot from a sporting activity or from a motor vehicle accident may predispose the joint to early wear and tear.
  • Severe flattening of the arch causes a change in the pressure distribution to that joint area.

SYMPTOMS:

  • Pain and diffuse tenderness to the outside of the midfoot area.
  • Loss of motion to the foot moving it up and down or side to side in the midfoot region.
  • Pain with activity, especially on an uneven surface.
  • Stiffness to the foot that may be relieved temporarily by weightbearing but gets progressively worse as the day goes on.

X-RAYS:

  • Reveal spurring around the joint region. 
  • Joint space narrowing may also be present.  However, it is often accompanied by arthritic changes in other joints around the midfoot and outer foot region.

TREATMENT:

  • Early identification as to the cause and degree of injury are important to provide a good long-term prognosis.
  • Injuries to the joint surface may require oral anti-inflammatories or a portico steroid injection to reduce the inflammation. 
  • Orthotics in the person’s shoes to unload the outer column of the foot and take stress off of the affected joint.
  • If bone spurring around the area is tender, it may be resected to provide long-term relief.
  • Rarely is surgery necessary in an isolated calcaneal cuboid joint injury that is arthritic.  However, if pain is unremitting, structural realignment of the joint or possibly fusing the joint may provide long-term benefits.