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Dr. Andrew Rynne

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Suggest treatment for swelling in the right ankle with intermittent pain

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Dr. Arnab Banerjee

Critical Care Specialist

Practicing since :2012

Answered : 1061 Questions

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Posted on Fri, 25 May 2018 in Internal Doctor Category
Question: Hi, My mom has been having swelling in the right leg ankles - sometimes with/without pain. And this causes foot pain for her often if she is not on rest. Blood/urine/kidney/liver/heart tests are normal. No sugar/not on medications also. XRAY on foot is also normal & She has flat feet. And so she is wearing MCR footware all the time. Please help if this is a bone (or) nerve issue. Her age is 47, weight = 71Kgs, height = 156cms.

Thanks,
XXXX
doctor
Answered by Dr. Arnab Banerjee 2 hours later
Brief Answer:
further evaluation needed

Detailed Answer:
Hello XXXXXXX Welcome to HealthcareMagic,
I've gone through your query and understand your concern for your mom,

First of all, please note, if Flat-feet's already been diagnosed (it's primarily a developmental disorder from childhood), then she should continue wearing the specialized foot-wear lifelong.

Secondly, if swelling is recently developed, then try to find out was there any underlying trauma/prolonged walking/stress involved before this or not...

Since blood investigations are already done and nothing detected, it may not be related to any metabolic issue. However, a possibility of ligament stress/nerve related issue may need to be looked into..X-ray won't be sufficient to detect this as it can only show the gross bony structures, for this an MRI of the Right lower leg needs to be done...

Another possibility is venous insufficiency which can also present in a similar way...For this, a color Doppler study of the venous and arterial system of the right leg should be done...

You can upload a picture/snapshot of the swelling here so that I can take a look at it...

Lastly, her BMI is overweight (29.2) for her age-group, being overweight with a pre-existing history of flat-feet can also produce such problems by creating chronic stress-induced injuries...I'd suggest you discuss this with her Doctor (preferably an Orthopedician) and proceed accordingly...

Please let me know if there's any other query that I can assist you with...

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Arnab Banerjee 8 hours later
Thanks Dr XXXXXXX for the reply. Please find the snapshot of the swelling my mom has on the right leg. The swelling is on the right side of the leg & she has pain on the left side of the leg. The swelling is recently developed in < 1yr. Please suggest what could be the problem behind this.

Thanks,
XXXX
doctor
Answered by Dr. Arnab Banerjee 2 hours later
Brief Answer:
follow as already advised...

Detailed Answer:
Welcome back,
Thanks for following up,

I've reviewed the attached images of the right lower leg...I believe you meant to say, the swelling is on the right side of the right leg while the pain she has is on the left side(of the right leg only)...Yes, the swelling is quite apparent there...

As you've already mentioned all blood tests were normal (I believe the Uric acid level was also checked there), so not going into those details...

She needs to be examined by an Orthopedician followed by some further imaging studies (as already explained, specifically a Doppler study of the Veno-arterial system to rule out any chronic vascular insufficiency and an MRI of the affected Right lower limb to rule out any soft tissue injury)...

Nothing to worry, as with timely diagnosis treatment is quite effective too...

Please let me know if there are any further concerns...

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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