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Suggest Remedies For Severe Ankle Pain And Fever

Posted on Mon, 9 May 2016

Question: Hello doctor,
My wife had a pregnancy which we aborted using pills Misoprostol was taken 2/15.
My elder son aged 6.5 yrs came home last friday 2/19 with fever and body pain and my wife and myself caught up with the viral fever next day Saturday 2/20. We went to doctor Sunday 2/21 and my wife temperature was 103.2 and doctor gave pain shots and tylenol for fever. Temperature did come down but by Monday 2/22 early morning when she was sleeping she got some severe ankle pain which looked llike a nerve pull. We tried applying ice pack on the area but it did not help. Next day 2/23 we went again to doctor and was prescribed prednisone 50 mg and tylenol codeine #3. The pain goes down when she is having the tablet but it comes back after every 4-6 hours. She is in severe pain and cannot be able to keep her left foot down on the floor and is not able to walk. Please suggest and guide. Thanks.

Answered by Dr. Dr. Muhammad Sareer Khalil (43 minutes later)

Brief Answer:
Ankle pain and fever

Detailed Answer:
Hello and Welcome

I appreciate your concern

The ankle pain, response to steroids, recurrence point towards an inflammatory process involving the joint. As its a single joint, septic arthritis must be excluded. If there is associated swelling, warmth, tenderness and edema then the fluid present in the joint should be aspirated and sent for examination.

RA factor, anti CCP, ESR, FBC, ANA profile, Uric acid levels, Urine R/E plus culture, FBC plus blood cultures should be taken in the presence of the fever and ankle pain.

NSAIDs are first line treatment and steroids like prednisolone are resorted to in severe inflammatory cases. Piroxicam and prednisolone can be continued with PPI cover to avoid GI erosion , ulceration.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

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Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (9 minutes later)

Urine test was done and it came up normal.
Is this normal post viral fever? how long does it take to recover.
Anything apart from the medication can be done at home?

Answered by Dr. Dr. Muhammad Sareer Khalil (26 minutes later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

This can occur as a sequelae of the viral illness. However, I'm more interested in ruling out any serious joint disease. If it's appropriate and there is no overlying cellulitis or bleeding diathesis then joint aspirate should be done to determine if there is degenerative, inflammatory or septic phenomenon. One can't say for sure how long it will take to recover. You can try applying ice and taking OTC NSAIDS for pain relief. Rest of the work up and treatment must involve a doctor.

wishing you best of health

let me know if you have any query

Thanks

Dr M.S Khalil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar