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Had swollen ankle, bruise on foot easily, weight gain. Blood sugar and heart test normal. Recommendation?

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General & Family Physician
Practicing since : 2009
Answered : 9398 Questions
I have had a swollen right ankle for a few weeks, and get bruises on the top of my foot verily easily (eg by kneeling down). It has been like this off and on for a few weeks, since I was laid up in bed for a while with a broken collarbone I think. I have also put on a lot of weight too due to inactivity - I'm now 140kg. My blood sugar was OK as of last week and I had some heart tests last year while diagnosing a hiatus hernia - all clear on the cardiac front. I'm a 42 year old male, with a bit of a history of health anxiety, if I'm honest. Walking seems to bring the swelling down, so I am walking it cycling 5 miles every other day.
Posted Thu, 27 Jun 2013 in Bones, Muscles and Joints
Answered by Dr. Shoaib Khan 48 minutes later
Hello XXXXXXX and welcome to XXXXXXX

Based on the information provided by you, let me shed some light on a few facts that would make it a that bit simpler to understand your presentation:
-Swelling is present in the ankle (which is present at the periphery of our body). Blood circulation is best at the center, around the heart; and poor around the peripheries (i.e. tips of finger, feet, etc.). This indicates a circulatory problem

-As mentioned by you, physical activity seems to bring the swelling down. What does physical activity do? Improve circulation. So, this again points towards a circulatory problem

-Easily bruising (just by kneeling down): One of the most common causes of easy bruising, in the absence of other pathological conditions are:
+Ageing capillaries (that weaken and become more fragile) -- again a circulatory problem
+Thinning skin (which is an age-related condition)

In my opinion, from the facts provided by you, I would suspect a circulatory problem. Now, this can be caused due to various conditions, let me list some of the most common ones:
-Cardiac ailments (which you have ruled out, although it would be better if you could re-check your cardiac profile)
-Vascular problems (a Doppler ultrasound of the affected leg will help rule out/diagnose any abnormalities, and a blood test for coagulation profile)
-Kidney abnormalities (blood test to check your renal function)
-Poor physical activity
-Conditions like hypertension, diabetes, etc.

So, as long as the physical activity helps, please continue with it, and if you wish, you could go about the above investigations to find out the cause.

I hope this helps. Please feel free to write back to me for any further clarifications. I would be more than happy to help you.

Take care.
Above answer was peer-reviewed by
Follow-up: Had swollen ankle, bruise on foot easily, weight gain. Blood sugar and heart test normal. Recommendation? 10 hours later
Thank you. I'm assuming from the tone of your email that you don't see this as a critically urgent thing. If not, I think I will continue to get more exercise and lose a few more pounds, then go and see my Doctor for tests if it doesn't improve. I am going on holiday for a week from today, just in the UK, so I hope you can confirm that this is OK to do.


Answered by Dr. Shoaib Khan 34 minutes later
Hello once again XXXXXXX

Yes, this does not seem like an emergency. I am especially reassured as you have recently conducted a cardiac profile, which reported normal values.

I would say this presentation is due to decreased physical activity and a gain in weight, I am sure it will get better with increased physical activity and once you lose a few pounds.

Have a pleasant vacation and do write to me if you feel a worsening of your symptoms/condition, or on the appearance of any new symptoms, which I feel is highly unlikely; but I just want you to know that I am always available.

Take care XXXXXXX have a blast!
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