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What Causes Swelling In The Ankles And Feet With Severe Knee Pain?

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Posted on Tue, 8 Nov 2016
Question: I am 77 y.o. and am fairly good health except I have severe osteoarthritis in knees, shoulders, elbows and ankles. I am taking Hydroco/APAP 5-325 acetaminophen 3x a day, plus Tramodol Hydrochloride ER once a day for breakthrough pain, My doctor is sending me to a hematologist as my white cell count is low. My problem is swelling in both lower legs, ankle and feet. They are about 2 inches bigger than normal.
I take Hydrochlorothiazide for this condition but things are getting worse. Legs & feet inflamed but cold. My pain in my knees is so bad I can only walk about 6 steps with a walker. XXXX

No known heart problems. Two of my parathyroids are dormant, no medications ordered nor surgery necessary at this time. Lungs extra ordinary clear for a 7 y.o
Never smoked or used illicit drugs or alcohol. I didn't know what specialist as for my osteoarthritis I have had a Rheumatologist for 30 years. All other doctors are MedStar and I have been a patient there 3 years. Arthritis document by MRI and other scans. Thyroid checked by an endocrinoligist. In addition to the pain in my knees, for about 8 inches below the knee and all around it the area feels very bruised but on the skin no bruising can be seen.
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Answered by Dr. Shehzad Topiwala (4 hours later)
Brief Answer:
Rule out clot

Detailed Answer:
Sorry to learn about your bothersome symptoms.

There is a condition called DVT ie Deep Vein Thrombosis. It is a worrisome problem because the clot can travel to the lungs to cause further major problems.
Request your healthcare provider to consider an Ultrasound examination of the leg to evaluate for this possibility.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid although you have mentioned your endocrinologist checked it)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)

None of these tests require any fasting and can be done at any time of the day
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

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

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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What Causes Swelling In The Ankles And Feet With Severe Knee Pain?

Brief Answer: Rule out clot Detailed Answer: Sorry to learn about your bothersome symptoms. There is a condition called DVT ie Deep Vein Thrombosis. It is a worrisome problem because the clot can travel to the lungs to cause further major problems. Request your healthcare provider to consider an Ultrasound examination of the leg to evaluate for this possibility. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) TSH (checks your thyroid although you have mentioned your endocrinologist checked it) 25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter) None of these tests require any fasting and can be done at any time of the day