Ankle Swelling: Causes and Solutions for Chronic Injuries

Q: Ankle Swelling: Causes and Solutions for Chronic Injuries

Question 1： Chronic ankle sprains or post-traumatic arthritis of the ankle joint caused by ligament laxity may lead to swelling. <br>Question 2： In principle, habitual dislocation of the ankle joint is uncommon and is mostly due to ligament laxity. <br>Dislocation： X-rays can rev

Bilateral ankle swelling?

Hello Dr.
Huang,
I sustained injuries while playing basketball during my high school years, often experiencing severe sprains (and dislocations).
In the past, I would self-treat at a local martial arts clinic with ointments and massages.
I continued to play basketball before fully recovering, which led to this cycle repeating itself (over 20 times combined for both ankles).
Now, I have noticeable swelling in both ankle joints (specifically on the outer side above the foot).
However, I have not engaged in vigorous exercise for over three years, and the affected areas do not cause pain (just a feeling of discomfort and a frequent urge to stretch the area).
I often experience sprains and dislocations even while walking on flat surfaces (after stopping exercise).
X-rays taken at the hospital showed no significant symptoms until recently when a stress X-ray revealed that the lateral ligament on my right foot is lax (which may result in one bone being longer?).
This makes it easier for me to sprain or dislocate.
However, no symptoms were detected in my left foot.
I have a few questions:
1.
If there are no issues with my left foot, why is there such significant swelling (without pain)?
2.
Is my right foot experiencing habitual dislocation? Can habitual dislocation be detected through X-rays? What are the clinical symptoms?
3.
I would like to thoroughly understand the underlying issues with my ankles.
Should I undergo additional examinations?
I appreciate your time and assistance, Dr.
Huang.
Thank you very much.

badooe, 20~29 year old female. Ask Date: 2003/06/15

Dr. Huang Longde reply Orthopedics

Question 1: Chronic ankle sprains or post-traumatic arthritis of the ankle joint caused by ligament laxity may lead to swelling.
Question 2: In principle, habitual dislocation of the ankle joint is uncommon and is mostly due to ligament laxity.
Dislocation: X-rays can reveal ligament laxity, but it is not easily detectable; clinical symptoms include swelling, pain, and difficulty walking.
Question 3: For a thorough understanding, please visit a hospital for evaluation and treatment by an orthopedic specialist or a sports medicine physician.

Reply Date: 2003/06/15

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your ankle swelling and chronic injuries. Based on your description, it seems that you have a history of recurrent ankle sprains and dislocations, which can lead to long-term complications, including joint instability and swelling. Let’s address your questions one by one.

1. Why is the left ankle swollen despite no apparent issues?
Swelling in the absence of pain can be attributed to several factors. One possibility is that the left ankle may have developed compensatory mechanisms due to the chronic issues in your right ankle. When one joint is unstable or injured, the body often compensates by altering movement patterns, which can lead to overuse or strain in other areas, even if they are not directly injured. Additionally, chronic swelling can sometimes occur due to changes in the soft tissue or ligaments surrounding the joint, which may not be visible on standard X-rays. It’s also possible that there is some underlying inflammation or synovitis that is contributing to the swelling.

2. Is the right ankle experiencing habitual dislocations, and can X-rays detect this?
Habitual dislocations or recurrent sprains can indeed be a result of ligamentous laxity or instability, which may not always be visible on standard X-rays. X-rays primarily show bone structure and alignment, but they do not provide detailed information about soft tissues, such as ligaments and tendons. If you have been diagnosed with a laxity in the lateral ligaments of your right ankle, this could explain the recurrent sprains and the feeling of instability. Clinical symptoms of habitual dislocation may include a sensation of the ankle "giving way," frequent sprains, and sometimes a feeling of discomfort or instability during activities. To further evaluate the integrity of the ligaments, an MRI or ultrasound may be necessary, as these imaging modalities can provide a clearer picture of soft tissue structures.

3. What further examinations should be conducted to understand the ankle issues?
Given your history and the current symptoms, I recommend a comprehensive evaluation by an orthopedic specialist. This may include:
- MRI or Ultrasound: These imaging techniques can help assess the condition of the ligaments, tendons, and any potential cartilage damage.

- Functional Assessment: A physical therapist can evaluate your ankle's range of motion, strength, and stability. They can also provide insights into any compensatory movement patterns that may be contributing to your symptoms.

- Balance and Proprioception Testing: Since you mentioned frequent sprains, assessing your balance and proprioception (the sense of joint position) can be beneficial. This can help identify any deficits that may increase your risk of further injuries.

In conclusion, it is crucial to address these chronic issues to prevent further complications. While the absence of pain is a positive sign, the swelling and history of instability warrant further investigation. A tailored rehabilitation program focusing on strengthening the ankle, improving proprioception, and correcting any movement patterns may be beneficial.
Please consult with an orthopedic specialist to discuss these options and develop a comprehensive treatment plan. Your proactive approach to understanding and addressing these issues is commendable, and I wish you the best in your recovery journey.

Best regards,
Doctor Q&A Teams

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