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Suggest Treatment For Swollen And Painful Ankles

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Posted on Mon, 22 Sep 2014
Question: Both ankles are swollen and painful, almost half way up to the knees...what causes this? Blood pressure is normally low (@ 110/80), healthy, walk 3-6 miles 5/6 times a week. Take pravastatin 40 mg for high cholesterol. No other health issues.
doctor
Answered by Dr. Dr. Shruti Rijhwani (23 minutes later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thank you for posting your query .

I have gone through your entire problem . In my opinion some investigations will be required before giving you a conclusive diagnosis. The most common in your scenario will be varicose veins which can give rise to ankle swelling extending till knees even . For ruling this out a USG doppler of legs is required . Second thyroid status needs to be checked , Hypothyroidism can present like this .

If the swelling is pitting then a 2 D echo is recommended . It does not look like arthritic swelling as it would be grossly limited to the joint only . These are the most common conditions and needs to be ruled out in your case. Till then keep your legs elevated while lying down will help you a bit . Treatment can be given only when cause is established.

Take care.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Shruti Rijhwani (8 minutes later)
Varicose veins are normally visible from the skin, are they not? There are no blue vein marking on either leg. The swellings are "hard" to the touch and there is no pitting. The swelling is toward the inner part of the leg, above each ankle, from above the ankle to the mid-line of the back of the ankle, therefore, about 1/4 of each leg in the ankle area. Internist checked thyroid less than 1 year ago and it's supposedly normal. Suppose an appointment is required.
doctor
Answered by Dr. Dr. Shruti Rijhwani (11 minutes later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thanks for reverting back.

You are absolutely right in saying so varicose veins will have a bluish discoloration around . Thyroid levels can vary if a gap of 1 year is there since last testing .

Physical examination is very important to the extent diagnosis can be made by just examining the swelling .So it would be good if you discuss all these things with your treating doctor also . I would like to know if you had any infection like urinary tract infection or stomach upset in recent past because a possibilty of reactive arthritis or erythema nodosum does exist .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Shruti Rijhwani (5 minutes later)
No, Dr. there have been no urinary tract infections nor upset stomach. I do suffer from fibromyalgia, however. Normally when I have a flare up, there are "hard knots" in areas throughout my body. Might this be simply a new area for it, you think? If the thyroid is the problem - my mother died from a failed thyroid that was not diagnosed - what test should I request?
Thank you
doctor
Answered by Dr. Dr. Shruti Rijhwani (24 minutes later)
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thanks for reverting back.

Then there is no possibilty of reactive arthritis . Yes fibromyalgia can present like this but then it will be hard painful swelling but not increase on joint movement passively and would not be warm ( temperature will not be raised over the joint ). That would require examination to determine what is the etiology.

If you have a family history of thyroid it is more important to get it checked . You will need to get a S. TSH , Free T3 , Free T4 done with blood sample to be given fasting .

Get well soon.

Dr. Shruti
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

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

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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Suggest Treatment For Swollen And Painful Ankles

Brief Answer: Follows. Detailed Answer: Dear Madam, Thank you for posting your query . I have gone through your entire problem . In my opinion some investigations will be required before giving you a conclusive diagnosis. The most common in your scenario will be varicose veins which can give rise to ankle swelling extending till knees even . For ruling this out a USG doppler of legs is required . Second thyroid status needs to be checked , Hypothyroidism can present like this . If the swelling is pitting then a 2 D echo is recommended . It does not look like arthritic swelling as it would be grossly limited to the joint only . These are the most common conditions and needs to be ruled out in your case. Till then keep your legs elevated while lying down will help you a bit . Treatment can be given only when cause is established. Take care. Dr. Shruti