Discussions By Condition: I cannot get a diagnosis.

Ankles swelling, the Left more than the Right

Posted In: I cannot get a diagnosis. 10 Replies
  • Posted By: cinviolin
  • June 5, 2008
  • 06:03 PM

I have been having a problem for the past 5 months with ankle swelling. Here's whats been happening:From Jan. - April I didn't get my period, I'm not pregnant. I went to two doctors and had blood work done and an exam done by an OBGYN doc. and they all confirmed that I wasn't pregnant. The doc. had to give me medicine to induce the period. I got my period in April. All through this time, I have been having ankle swelling, each month getting worse and worse. My left ankle and foot is almost twice as bad as the right. At times they are so swollen that i can't even wear shoes. I am only 27 years old and have never had a problem before this. I don't have any diseases or illnesses. I'm not on medicine. My blood work comes back completly normal. In the morning my ankles will be ok. As the day goes on, they get more and more swollen. It doesn't matter what I eat, they swell. It doesn't matter what I'm doing, they swell. And it is strange that one is worse than the other. I'm very concerned about this and I don't knwo what to do. The doctors just tell me to take water pills. That isn't possible when I have to work all day. I also can't stay at home with my feet up all day. I have never had this problem ever and no one can seem to help me with it. Has this ever happened to anyone else?

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10 Replies:

  • well i guess might be due to Prolonged standing,what work do you do ?as you have said you don't have any medications taken and you don't have any medical diseases.You can try this:Elevate your legs above your heart while lying down.Exercise your legs. This helps pump fluid from your legs back to your heart. Wear support stockingsTry to follow a low-salt diet, which may reduce fluid retention and swelling.
    010081 5 Replies Flag this Response
  • Cinviolin,You do not write anything about your heart. Swollen ankles can indicate irregular heart beat. Have they examined your heart? Can you feel if you have irregular pulse?The fact that your left ankle is more swollen than the right one, can indicate that you suffer from May-Thurner syndrome (the right iliac artery compresses the left iliac vein against the spine) which makes liquid accumulate mostly in the left leg. The typical patient is a young or middle-aged woman.I have been suffering from May-Thurner syndrome with terrible consequences, because it was left undiagnosed for 12 years. I would like to help you. Most doctors have no idea about this, the best ones are in US.Are you in US?Greetings from EuropeS
    Felsen 510 Replies Flag this Response
  • Felsen, Thank you for responding to my posting. I have been to the doctor, and they have listened to my heart, but I have not had any testing done on it. I have never been diagnosed with irregular heartbeats before, but again, I have not really been tested. I read a little bit of info on this condition, and it said that symptons can come out more if you exercise. In this same period of time of getting swollen ankles, i was exercising a lot more. Did both of your ankles swell, or just the left? I have it in both, but again, twice as bad in the left. Are there any other symptoms? What is the treatment options? Thanks for you help Felsen. ~C
    cinviolin 3 Replies Flag this Response
  • Felsen, PS: I am in the US
    cinviolin 3 Replies Flag this Response
  • Also, I have had 2 ultrasounds done on both legs. They were checking for blood clots. They didn't find any, and it showed that the blood in my legs was flowing normally. With May-Thurner Syndrome will that show up in an ultrasound, does it always cause clotting, or is it something that might not show up?
    cinviolin 3 Replies Flag this Response
  • Cinviolin,It is good that they have checked your legs with ultasound because it means that they found no clots. The ultrasound in a May-thurner patient will show normal blood flow in legs. Unfortunately the risk for clots is substantial in May-Thurner syndrome. The ultrasound can not diagnose May.Thurner because the vein compression is at the level of your belly and deep in pelvis, just in front of your spine. A phlebography can sometimes show it but far from always. There is only one way to be sure, it is to make IVUS (intravascular ultrasound). You are lucky to be in US, I’m happy for you. The most experienced team in the world for this condition is in River Oaks Hospital in Jackson, Miss. It is dr Neglen and dr Raju. They literally saved my life. I hope that you are somewhere close to Miss.May-Thurner can give many different symptoms. The most common is swelling, mostly in left leg but in my case it was only pain with hardly any swelling, that’s why for 12 years I was told it was “all in my head”. You are lucky to have a visible symptom. The treatment is very simple. They put a stent in your iliac vein. You are in the hospital for one day. There is very little risk for complications. The best prognosis is if you don’t wait too long with the treatment, because the stasis is very strenuous on your veins. If you develop a clot, it gets more complicated. There is also risk for leg ulcers.I can’t figure out how your period fits in all this. It might not have anything to do with this. Maybe you have two separate conditions. But I still think you need a proper heart examination by a cardiologist.Best of luck! Felsen
    Felsen 510 Replies Flag this Response
  • Turner syndrome? Hereditary angioedema?
    aquila 1,263 Replies Flag this Response
  • Hi there! I have ankle swelling and foot all on the right side. I had an ultra sound to rule out blood clot. My doc. now wants me to have a MRI scan of my stomach, pelvis, as he said this can very well be something laying on organs. I have to fast the entire day before, then drink something they give you. wait for 2 hrs. then get the scan (inside a tunnal) So, why don't you ask your Dr. about this. My appointment is coming up soon for this. Good luck and God bless you~Desi :)
    Desiray' 2 Replies Flag this Response
  • Hi~Sounds like we may have some things in common! In January of this year I experiences what I believed to be a relatively harmless spider bite. My right ankle was mildly swollen and getting a big itchy bump on it...the nurse at my school (I'm a teacher) thought it looked like a spider bite. There was no infection, just swelling. Shortly there after one of my basketball players kicked me very hard in the shin while scrimmaging, it was very painful, but I've experiences this often. The result was a very tender, swollen, darkened area about 5 inches long on my right shin. When the swelling didn't go away after 2 weeks I went to the doctor. My family doc insisted it was Cellulits, an infection in the skin, she thought my shin got an infection and we were seeing the results of this in my ankle (although I was relatively sure this was wrong). She put me on anti-biotics. No change in 7 days so I went back. She insisted cellulits and gave me a shot of anti-biotics, thinking I needed a higher dose. Again, after several days, no change. The swelling was getting more and more uncomfortable. Not painful, just uncomfortable. I too was out of shoes. When I went back my first doc wasn't there, my second family doctor was pretty sure it wasn't Cellulitis so he had a couple of tests done. Concerned it was a blood clot I got my first Vascular Ultrasound as well as an XRay of my shin (they couldn't let go of the shin, despite my insistence I had this injury many times). Both came back normal, so I stayed on the anti-biotics and made an appointment for the following Monday. By the time I went back it got so bad I couldn't walk anymore without crutches. The swelling made the back of my ankle so tight it hurt to walk (although the ankle itself and swelling didn't hurt). My ankle was about three times the normal size. At this point I was googling up a storm and finding nothing, other than it didn't look anything like Cellulitis. Visit #4 to my family doc resulted in me going to the ER to be admitted to the Infectious Disease Ward of the hospital. After sitting there for two hours those doctors figured that it was just a different type of infection, so they splinted it and gave me the meds used to treat MRSA and referred me to a Foot and Ankle specialist. Foot and Ankle guy thought I had torn my Saphenous Vein which had caused blood to pool and make my ankle swell drastically as the body tried to break down the blood. He said I needed a Vascular Ultrasound, he was sure that the last guy did it wrong, so I had VA #2. This showed nothing also. Foot and Ankle guys response was well let's just wait two weeks (it had been a 1.5 months at this point). I was quite annoyed by this response so I called my family doc #2 and asked what to do. He hooked me up with the top Infectious Disease doc in our area. She tested me for a million things (27 blood tests, 2 urine tests, Chest XRay, lower leg MRI - that pesky shin again). They all came back showing pretty much nothing, except an extremely elevated type of protein (glyco2 beta-protein). This was pretty much the max my ankle ever got. It felt like it might pop off my body. I couldn't wear socks and the only shoes were the Adidas sandals that velcro shut. Because of the glyco-protein she referred me to a Rheumatologist. As this was happening the two weeks were up with the Foot and Ankle guy, so I went back there. My ankle did start to start de-swelling at this point (a little over 2 months in). He had another MRI done, an ankle this time as well as a Bone Scan and an ankle X-Ray (people were finally letting go of the shin). The results of all those tests came back showing it might be something called Reflexive Sympathic Disorder or Complex Regional Pain Syndrome (although I was missing most of the major symptoms). RSD/CRPS is considered to be a chronic and often degenerative nervous system disease. Foot and Ankle referred me to a Pain Specialist. The pain specialist, who specialized in RSD/CRPS he did a Lumbar Nerve Block, to hopefully reduce the swelling. The swelling was still around...but my foot fit into my sneakers...the swelling was spilling over the tops, but at least it was in. They also gave me a pain patch called a "Flector Patch", which was like those IcyHot Patches they have for your back, it distributes an anti-inflammatory directly into the area where you place it, as well as putting me on Lyrica (which is used to treat nervous system diseases). Things seemed to calm down for a while. My rheumatologist seemed to agree with this diagnosis. The foot and ankle guy said wait another 4 weeks with no exercise. I tried going back a little earlier, and the swelling started again. I had to go back to the rheumatologist at 3 months from my first blood tests (4 months from beginning) to have my proteins re-tested. When I went back surprise, surprise, my LEFT ankle started swelling. It was moderate at first, but continued to get worse. Eventually I started to get painful red bumps on my knees. My right foot, although not swollen became remarkably painful. My rheumatogist suspected a disease called sarcoidosis and she ordered another 10 blood tests, urine test, and a Chest XRay. The blood work and XRay came back normal. Additionally I went to a Dermatologist who biopsied the bumps on my knees and an Opthamologist who looked at my eyes (nothing wrong with my eyes, thank goodness!). The biopsy revealed something called erythema nodosum, a symptom of sarcoidosis. Sarcoidosis is a disease that primarily affects the lungs (I HAD asthma issues earlier this year) but can also cause symptoms similar to arthritis (they checked for rheumatoid arthritis already, that was negative). The Chest XRay should show granulomas (I think) on your lymph nodes, they didn't show up. They have now done a Cat Scan, with contrast, to see if it shows anything (results not in). It is my belief that I may have always had the sarcoidosis, that this was what caused the intense swelling in my ankles. I read that many doctors miss this diagnosis. Some of the many symptoms is fatigue, difficulty breathing, unexplained weight loss, and depression. Most doctors dismiss these symptoms. You may want to get checked for this. It is relatively harmless. The treatment is Predisone (booooo), but right now I just have Ibprofen 800mg and Vicodin for the pain. You sound like you are going through some similar things to what I went through. Sorry for the long post but wanted to letyou know what you may have on the horizon. Let me know if you have any questions.
    shm_helene 1 Replies Flag this Response
  • Hi~Sounds like we may have some things in common! In January of this year I experiences what I believed to be a relatively harmless spider bite. My right ankle was mildly swollen and getting a big itchy bump on it...the nurse at my school (I'm a teacher) thought it looked like a spider bite. There was no infection, just swelling. Shortly there after one of my basketball players kicked me very hard in the shin while scrimmaging, it was very painful, but I've experiences this often. The result was a very tender, swollen, darkened area about 5 inches long on my right shin. When the swelling didn't go away after 2 weeks I went to the doctor. My family doc insisted it was Cellulits, an infection in the skin, she thought my shin got an infection and we were seeing the results of this in my ankle (although I was relatively sure this was wrong). She put me on anti-biotics. No change in 7 days so I went back. She insisted cellulits and gave me a shot of anti-biotics, thinking I needed a higher dose. Again, after several days, no change. The swelling was getting more and more uncomfortable. Not painful, just uncomfortable. I too was out of shoes. When I went back my first doc wasn't there, my second family doctor was pretty sure it wasn't Cellulitis so he had a couple of tests done. Concerned it was a blood clot I got my first Vascular Ultrasound as well as an XRay of my shin (they couldn't let go of the shin, despite my insistence I had this injury many times). Both came back normal, so I stayed on the anti-biotics and made an appointment for the following Monday. By the time I went back it got so bad I couldn't walk anymore without crutches. The swelling made the back of my ankle so tight it hurt to walk (although the ankle itself and swelling didn't hurt). My ankle was about three times the normal size. At this point I was googling up a storm and finding nothing, other than it didn't look anything like Cellulitis. Visit #4 to my family doc resulted in me going to the ER to be admitted to the Infectious Disease Ward of the hospital. After sitting there for two hours those doctors figured that it was just a different type of infection, so they splinted it and gave me the meds used to treat MRSA and referred me to a Foot and Ankle specialist. Foot and Ankle guy thought I had torn my Saphenous Vein which had caused blood to pool and make my ankle swell drastically as the body tried to break down the blood. He said I needed a Vascular Ultrasound, he was sure that the last guy did it wrong, so I had VA #2. This showed nothing also. Foot and Ankle guys response was well let's just wait two weeks (it had been a 1.5 months at this point). I was quite annoyed by this response so I called my family doc #2 and asked what to do. He hooked me up with the top Infectious Disease doc in our area. She tested me for a million things (27 blood tests, 2 urine tests, Chest XRay, lower leg MRI - that pesky shin again). They all came back showing pretty much nothing, except an extremely elevated type of protein (glyco2 beta-protein). This was pretty much the max my ankle ever got. It felt like it might pop off my body. I couldn't wear socks and the only shoes were the Adidas sandals that velcro shut. Because of the glyco-protein she referred me to a Rheumatologist. As this was happening the two weeks were up with the Foot and Ankle guy, so I went back there. My ankle did start to start de-swelling at this point (a little over 2 months in). He had another MRI done, an ankle this time as well as a Bone Scan and an ankle X-Ray (people were finally letting go of the shin). The results of all those tests came back showing it might be something called Reflexive Sympathic Disorder or Complex Regional Pain Syndrome (although I was missing most of the major symptoms). RSD/CRPS is considered to be a chronic and often degenerative nervous system disease. Foot and Ankle referred me to a Pain Specialist. The pain specialist, who specialized in RSD/CRPS he did a Lumbar Nerve Block, to hopefully reduce the swelling. The swelling was still around...but my foot fit into my sneakers...the swelling was spilling over the tops, but at least it was in. They also gave me a pain patch called a "Flector Patch", which was like those IcyHot Patches they have for your back, it distributes an anti-inflammatory directly into the area where you place it, as well as putting me on Lyrica (which is used to treat nervous system diseases). Things seemed to calm down for a while. My rheumatologist seemed to agree with this diagnosis. The foot and ankle guy said wait another 4 weeks with no exercise. I tried going back a little earlier, and the swelling started again. I had to go back to the rheumatologist at 3 months from my first blood tests (4 months from beginning) to have my proteins re-tested. When I went back surprise, surprise, my LEFT ankle started swelling. It was moderate at first, but continued to get worse. Eventually I started to get painful red bumps on my knees. My right foot, although not swollen became remarkably painful. My rheumatogist suspected a disease called sarcoidosis and she ordered another 10 blood tests, urine test, and a Chest XRay. The blood work and XRay came back normal. Additionally I went to a Dermatologist who biopsied the bumps on my knees and an Opthamologist who looked at my eyes (nothing wrong with my eyes, thank goodness!). The biopsy revealed something called erythema nodosum, a symptom of sarcoidosis. Sarcoidosis is a disease that primarily affects the lungs (I HAD asthma issues earlier this year) but can also cause symptoms similar to arthritis (they checked for rheumatoid arthritis already, that was negative). The Chest XRay should show granulomas (I think) on your lymph nodes, they didn't show up. They have now done a Cat Scan, with contrast, to see if it shows anything (results not in). It is my belief that I may have always had the sarcoidosis, that this was what caused the intense swelling in my ankles. I read that many doctors miss this diagnosis. Some of the many symptoms is fatigue, difficulty breathing, unexplained weight loss, and depression. Most doctors dismiss these symptoms. You may want to get checked for this. It is relatively harmless. The treatment is Predisone (booooo), but right now I just have Ibprofen 800mg and Vicodin for the pain. You sound like you are going through some similar things to what I went through. Sorry for the long post but wanted to letyou know what you may have on the horizon. Let me know if you have any questions.Swelling in just the left ankle, also associated with joint and muscle pain, can be fibromyalgia.
    Anonymous 42,789 Replies
    • November 8, 2009
    • 00:33 PM
    • 0
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