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    Suggest treatment for swollen ankles and muscle pain

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Posted on Thu, 27 Jul 2017 in Veins and Arteries
Question: I AM SUFFERING FROM VARIOUS SYMPTOMS ALL RELATED TO THE LOWER EXTREMITIES, IE. SWOLLEN ANKLES, BOTH, MUSCLE PAIN AND LOSS OF STRENGTH IN both L & R "calf portion" of my legs. Also suffering a sense of heaviness and fatigue at times. Left leg is cold during the night. This has been about 4 months Fatigue has been a problem for about one and one half year. Suddenly I didn't feel like myself . I am 78 years old and led an active lifestyle. I weigh about 195 lbs. Thank you for helping. My name is XXXXXXX
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Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would recommend performing some tests:

Detailed Answer:
Hello XXXXXXX

Thank you for asking on HCM!

I passed carefully through your question and would explain as follows:

1- The swollen ankles could be related to chronic inflammation or to fluid retention (possible heart failure, kidney or liver disorder). Chronic venous insufficiency can not be excluded either.

2- The pain and loss of muscle force in the lower limbs coupled with the sense of cold during the night could indicate possible chronic nerve damage or polyneuropathy.

Coming to this point, I would recommend consulting with your attending physician for a careful physical exam and some tests to investigate for the possible causes:

- a resting ECG and a cardiac ultrasound to exclude heart failure
- a chest X ray study
- complete blood count, PCR and ESR for inflammation
- fasting glucose and HbA1C for diabetes
- kidney and liver function tests
- blood electrolytes
- thyroid hormone levels (thyroid dysfunction can cause chronic fatigue and polineuropathy)
- vitamin B 12 levels for possible deficiency
- a urine analysis.

A doppler ultrasound of the leg vessels would help exclude possible chronic venous insuficiency.

A nerve conduction study (electroneurography) is needed to investigate for polineuropathy.

You should discuss with your doctor on the above tests.

Hope you will find this answer helpful!

Wishing good health,

Dr. Iliri

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

Cardiologist

Practicing since :2001

Answered : 7360 Questions

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