Why do I have swollen ankles or feet?

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Causes of Swollen Ankles or Feet

Swollen ankles or feet can be a symptom of various underlying conditions. This article synthesizes findings from multiple research studies to provide a comprehensive overview of potential causes.

Erythema Nodosum and Systemic Inflammation

Swollen ankles accompanied by erythema (redness) and heat can be indicative of systemic inflammation. One case study described a 41-year-old man with acute painful swelling of both ankles, morning stiffness, and fever, which later developed into erythema nodosum, a condition characterized by tender, red nodules on the legs. This suggests that systemic inflammatory conditions can manifest as swollen ankles.

Rheumatoid Arthritis and Synovitis

Rheumatoid arthritis (RA) is a common cause of ankle and foot swelling. Patients with RA often experience oedema (swelling) due to synovitis, an inflammation of the synovial membrane. Studies have shown that even in patients who appear to be in remission, residual synovitis can be detected via ultrasonography, indicating ongoing inflammation that may not be evident through physical examination alone . This persistent inflammation can lead to swollen ankles and feet, impacting physical function and quality of life.

Juvenile Idiopathic Arthritis (JIA)

In children, juvenile idiopathic arthritis (JIA) can cause swollen ankles. Research using ultrasound has shown that tenosynovitis (inflammation of the tendon sheath) is a prevalent finding in JIA patients with swollen ankles. This inflammation can occur with or without tibiotalar effusion (fluid accumulation in the ankle joint), suggesting that tenosynovitis is a significant contributor to ankle swelling in JIA.

Trauma and Injury

Ankle swelling can also result from trauma or injury. For instance, a case study of a man in his 30s who experienced a pronation twisting injury to his ankle after a fall showed that the injury led to immediate pain and swelling. This type of swelling is typically associated with joint effusion and reduced range of motion.

Celiac Disease

Celiac disease (CD) can present with extraintestinal symptoms, including swollen ankles. A case study of a 27-year-old male revealed that his ankle swelling was associated with polyneuropathy and other systemic symptoms. Upon diagnosis and treatment with a gluten-free diet, his symptoms, including ankle edema, improved significantly. This highlights the importance of considering CD in the differential diagnosis of unexplained ankle swelling.

Conclusion

Swollen ankles or feet can be caused by a variety of conditions, ranging from systemic inflammatory diseases like erythema nodosum and rheumatoid arthritis to trauma and celiac disease. Accurate diagnosis often requires a combination of clinical evaluation and diagnostic imaging or laboratory tests. Understanding the underlying cause is crucial for effective treatment and management.