The Causes of Ankle Swelling

The swelling of the lower leg and ankle is a common problem. Determining the cause of ankle swelling is the first step to finding an effective treatment. Once the cause of the ankle swelling is determined, effective treatment can be initiated.

Ankle swelling causes the accumulation of fluid within the ankle joint or in the soft tissues surrounding the ankle. Common causes of ankle swelling include the following.

Young woman having ankle pain
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Traumatic Injury

A traumatic injury to the leg, including an ankle sprain or a broken ankle, can be a cause of ankle swelling. Patients almost always remember the particular injury, but occasionally even subtle injuries can also lead to ankle swelling. Also, stress fractures can occur around the ankle joint leading to swelling.

Gout

Gout is due to the accumulation of uric acid crystals within the fluid of your ankle. Uric acid is a substance produced as part of metabolizing certain types of food and is normally excreted in the urine. People with gout abnormally accumulate uric acid crystals within joints, leading to inflammation and swelling.

Ankle Arthritis

Ankle arthritis is much less common than degenerative changes in other joints. However, ankle arthritis can occur and can be quite painful. Ankle arthritis is most common in patients with rheumatoid arthritis or in patients with a previous injury to the ankle joint. Surgical treatments for ankle arthritis depends on the severity of the condition. As arthritis progresses, the options are usually limited to either ankle fusion or ankle replacement surgery. In mild cases of arthritis, such as anterior impingement, a less-invasive ankle arthroscopy may be helpful in removing bone spurs.

Infection

Infection is an unusual cause of ankle swelling as seen with tuberculosis. Infections can either occur in the soft tissues around the ankle joint (cellulitis) or in the joint itself (septic joint). Infections can often be treated with medications alone, but may also require surgery.

Vascular Obstruction

Numerous problems with blood flow can impair normal circulation and lead to swelling around the ankles. This can result from venous insufficiency, or in some cases, a blood clot, also known as a deep venous thrombosis (DVT). This type of vascular problem usually occurs in one leg (not both) and leads to swelling of the soft tissues throughout the foot and ankle. The swelling can also extend further up the leg.

Treatment of a Swollen Ankle

It's important for the most effective treatment of ankle swelling that you have an understanding of the cause of the condition. For immediate treatment, it is safe to perform the typical 'R.I.C.E.' treatment of the swelling. This means that in the early stages, one should rest, ice, compress and elevate the swollen joint. Once the specific cause of swelling is understood, you can proceed with more targeted interventions to help eliminate the swelling.

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11 Sources
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  1. Gasparis AP, Kim PS, Dean SM, Khilnani NM, Labropoulos N. Diagnostic approach to lower limb edema. Phlebology. 2020;35(9):650-655. doi: 10.1177/0268355520938283

  2. Horst K, Greven J, Lüken H, et al. Trauma severity and its impact on local inflammation in extremity injury—insights from a combined trauma model in pigs. Front Immunol. 2020;10:3028. doi: 10.3389/fimmu.2019.03028

  3. Centers for Disease Control and Prevention. Gout.

  4. Li, F., Guo, H., Zou, J. et al. Urinary excretion of uric acid is negatively associated with albuminuria in patients with chronic kidney disease: a cross-sectional study. BMC Nephrol 19, 95 doi: 10.1186/s12882-018-0892-7

  5. Herrera-Pérez M, González-Martín D, Vallejo-Márquez M, Godoy-Santos AL, Valderrabano V, Tejero S. Ankle osteoarthritis aetiology. Journal of Clinical Medicine. 2021;10(19):4489. doi: 10.3390/jcm10194489

  6. Muller, P., Skene, S.S., Chowdhury, K. et al. A randomised, multi-centre trial of total ankle replacement versus ankle arthrodesis in the treatment of patients with end stage ankle osteoarthritis (TARVA): statistical analysis plan. Trials 21, 197 (2020). doi: 10.1186/s13063-019-3973-4

  7. Vaseenon T, Amendola A. Update on anterior ankle impingement. Curr Rev Musculoskelet Med. 2012;5(2):145-150. doi: 10.1007/s12178-012-9117-z

  8. Nayak B, Dash R, Mohapatra K, Panda G. Ankle and foot tuberculosis: A diagnostic dilemma. J Family Med Prim Care. 2014;3(2):129. doi: 10.4103/2249-4863.137629

  9. UpToDate. Surgical management of necrotizing soft tissue infections.

  10. Ho E, Omari A. Prevalence of acute deep vein thrombosis in patients with ankle and foot fractures treated with nonoperative management—a pilot study. Int J Angiol. 2017;26(01):053-059. doi: 10.1055/s-0035-1556054

  11. Fischer DC, Sckell A, Garkisch A, et al. Treatment of perioperative swelling by rest, ice, compression, and elevation (Rice) without and with additional application of negative pressure (Rice+) in patients with a unilateral ankle fracture: study protocol for a monocentric, evaluator-blinded randomized controlled pilot trial. Pilot Feasibility Stud. 2021;7(1):203. doi: 10.1186/s40814-021-00944-7

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