Swelling of the ankles

Swollen ankles and swollen feet are a common symptom and do not cause much discomfort or cause for concern, especially if you have been standing or walking a lot. Still, sometimes legs and ankles that remain swollen for a long time or are accompanied by other signs may indicate a serious problem in the body. The following article discusses some of the possible causes of swelling of the foot and ankle.

What is puffiness

In medical terms, edema is a transient abnormal enlargement of a body part or area not caused by cell proliferation. This is caused by the accumulation of fluid in the tissues. Puffiness can occur throughout the body (general swelling), or a specific part or organ may be affected by the problem. Swelling is usually not dangerous and is a common reaction to inflammation or bruising.

Edema is considered one of the five characteristics of inflammation; along with pain, warmth, redness, and loss of function. A part of the body may swell in response to injury, infection, or illness. Swelling, especially of the ankles, can occur if the blood is not circulating well. If water retention progresses to a symptomatic degree, edema is the result. Generalized swelling or massive edema (also called anasarca) is a common finding in seriously ill people. Although mild swelling is difficult to detect, especially in an overweight person. In contrast, massive edema is very evident.

Causes of swollen ankles

Pregnancy. When pregnancy occurs, swelling of the ankles and feet occurs. Sudden or excessive swelling, however, can be a sign of preeclampsia, a serious condition in which high blood pressure and protein in the urine develop from the twentieth week of pregnancy. If you experience severe swelling or it is accompanied by other signs such as abdominal pain, headaches, infrequent bladder emptying, nausea and vomiting, or blurred vision, then you should see a doctor.

Foot or ankle injury. Injury to the foot or ankle can cause swelling. The most common case is a sprained ankle, which occurs when an injury stretches the ligaments and puts the foot in an unnatural position. To reduce swelling from a foot or ankle injury, rest. Avoid walking on a swollen ankle or leg, use ice packs, wrap the leg or ankle in a compression bandage, and elevate the leg on a stool or pillow. If swelling and pain persist with home treatment, seek medical attention.

Side effect of the drug. Many medications cause swelling in the legs and ankles as a possible side effect. It can be:

• hormones such as estrogen (found in oral contraceptives and hormone replacement therapy) and testosterone;
• calcium channel blockers, a type of high blood pressure medication that includes: nifedipine, amlodipine, diltiazem, felodipine, and verapamil;
• steroids, including androgenic and anabolic steroids and corticosteroids such as prednisolone;
• antidepressants, including: tricyclics such as nortriptyline, desipramine, and amitriptyline (Elavil, Endep, Vanatrip); and monoamine oxidase (MAO) inhibitors such as phenelzine and tranylcypromine;
• non-steroidal anti-inflammatory drugs (NSAIDs);
• diabetic drugs.

If you suspect that swelling may be related to a drug you are taking, contact your doctor. Although the benefits of a drug may justify the swelling, more severe swelling suggests that the drug or dose needs to be changed.

Lymphedema. This is the stagnation of lymphatic fluid in the tissues, which can occur due to problems with the lymphatic vessels or after surgery to remove the lymph nodes. Lymph is a protein-rich fluid that is transported through an extensive network of blood vessels and capillaries. It is cleared through the lymph nodes, which trap and destroy unwanted substances (eg bacteria). However, if the patient has problems with the lymph nodes, the normal circulation of the lymphatic fluid stops. Lymph stasis impairs wound healing and can cause infectious diseases in the body. Lymphedema is common after radiation therapy or surgery to remove lymph nodes. If you’ve been treated for cancer and are experiencing lymph buildup, it’s worth contacting your healthcare provider.

Venous insufficiency. Swelling of the ankles and feet is often the first sign of venous insufficiency, a condition in which blood moves randomly through the veins from the legs to the heart. Normally, veins support the direction of circulation upwards with one-way valves. When they are damaged or weakened, some of the blood flows back down the vessels, and the interstitial fluid remains in the soft tissues of the legs, especially at the ankles. Chronic venous insufficiency leads to skin changes, skin ulcers and infection. If you are experiencing symptoms of venous insufficiency, you should visit a vascular surgeon.

Infection. Swelling in the legs and ankles can be a symptom of an infection. People diagnosed with diabetic neuropathy and any other nerve disease of the feet are at a higher risk of foot infections. If you have diabetes, it’s important to check your feet every day for blisters and sores because nerve damage can reduce pain and foot problems can escalate. If you notice swelling in your leg, contact your doctor immediately.

Blood clot. Blood clots that form in the veins of the legs can cause backflow of blood from the legs to the heart and cause swelling in the ankles and legs. Blood clots can be either superficial (found in veins under the skin) or deep (a condition referred to as deep vein thrombosis). Large clots can block one or more of the main veins in the legs. These blood clots can be life-threatening if they break off and go to the heart and lungs.If you have swelling in one leg, accompanied by pain, fever, and possibly discoloration of the affected area of ​​the leg, see a doctor immediately.Antiplatelet drugs and blood anticoagulants may be needed.

Disease of the heart, liver and kidneys. Sometimes swelling is a symptom of heart, kidney, or liver disease. Ankles that swell late at night (in the evening) are a sure sign of salt and water retention due to heart failure. Kidney disease can also cause swollen feet and ankles. When the kidneys do not function normally, fluid accumulates in the body.

Liver disease can affect the liver’s production of a protein called albumin, which keeps blood from leaking from blood vessels into tissues. Irregular release of albumin can lead to leakage of fluid. Gravity causes fluid to stagnate more in the legs and ankles, but it can also be found in the abdomen and chest. If your swelling is accompanied by other symptoms, including fatigue, loss of appetite, and weight gain, see your doctor right away. If you feel short of breath or chest pain, pressure or tightness, call an ambulance.

Diagnosis of puffiness

First of all, it is necessary to note the symptoms of swelling, which are a prerequisite for diagnosis:

• pastiness
• pronounced puffiness
• local swelling
• trophic disorders of the skin.

Recent food intake should be considered, especially in hospitalized patients who may be malnourished due to prolonged periods of anorexia, nausea, vomiting, gastrointestinal dysfunction, or starvation for research and treatment. Similarly, in hospitalized patients, the volume of intravenous infusions should be reviewed. The duration and rate of swelling of the legs should be established.

A family history of similar problems may be relevant. A past history of varicose veins, malignancy, radiation therapy, surgery, previous episodes of a tumor or leg infection, or deep vein thrombosis (possibly complications of surgery or childbirth) should be identified.

A complete physical examination should be performed. Common items of examination include the patient’s nutritional status and abnormal pigmentation of the skin, sclera, and mucous membranes. Examine the abdomen and lower extremities for suspicious skin lesions and vascular abnormalities, surgical scarring, and signs suggestive of radiation therapy (skin atrophy, telangiectasia, scaly skin).

Swelling in one or both legs is confirmed by a doctor’s examination and certain tests. Be aware that the swollen body part may be sensitive to touch. Acute swelling is defined by slow, gentle pressure over the ankle. Lymphedema is characterized by swelling of the legs and feet, as well as swelling of the fingers. In prolonged cases, intradermal vesicles, dry and scaly skin, and the appearance of “elephant skin” occur. The legs are examined for signs of venous disease (varicose veins, venous outbreaks, pigmentation, liposclerosis, eczema, venous ulceration).

The Trendelenburg test is also performed in the diagnosis of edema. The hips, knees and ankles should be examined along with the popliteal fossa. Groups of lymph nodes should also be examined. The doctor may prescribe an examination of the rectal and pelvic organs. Signs of inflammation (erythema, fever, swelling, decreased movement) with or without infection (pus) should be noted.