Signs
And Symptoms Of Ankle PainThe common denominator of all these conditons,
although so different, is pain in the ankle. This list
is only a part of all of the diagnostic possibilities. When the joint surface
or the synovial membranes of the joint are involved as in the case of an arthritic
condition, there is usually a decreased range of motion. There can also be
redness and swelling around the joint area. If there is an effusion, which is an accumulation
of inflammatory joint fluid, the bone markings can be hardly visible because of
the massive enlargement of the joint. The joint is then extraordinarily tender
and any motion in the joint becomes extremely painful. When there is end
stage arthritis in the ankle joint, fusion surgery may be the only
solution for pain control. With circulatory problems in the veins there is a dull
ache in the joint and varicose veins would be visible. Often there can be
an associated leg ulcer of the skin in the lower leg around the ankle, which does
not want to heal. In the case of arterial ciculation problems there is often intermittent
claudication. This means that the patient can walk a block or two, but then cramps
in the lower leg muscles set in and the patient is forced to stop walking and
to rest until walking can be resumed. The lack of oxygen in the muscles and ankle
joint are the cause for pain as lactic acid is accummulated irritating the nerve
endings. Complex regional pain syndrome is another
source of ankle pain. There are two types, called type I (formerly called "reflex
sympathetic dystrophy") and type II (formerly called "causalgia").
With type II (CRPS II) the injury ( often a "crush
injury") causes direct damage to a nerve in the skin or deeper in the body.
This pain syndrome sets in right away with a deep gnawing pain as well as another
type of pain that can be caused already by lightly touching the skin in the area.
In type I complex regional pain syndrome a similar pain
pattern develops, but there is a lag time of 2 to 3 months before this pain pattern
develops. Often following a fracture with casting, when the cast is taken off
such a CRPS I can develop unless aggressive physiotherapy to remobilize is done
right away. With cancer related ankle pain there would be clues that something
else is going on. For instance, there could be a history of breast cancer in a
woman and years later she may develop ankle pain. When tests are done it could
show that this is due to a single bony metastasis in the ankle bone or else this
might be just one of the many other bone metastses that develop at that time.
A bone scan would show other locations of bone metastases. In multiple myeloma
there would be several other myeloma bone lesions and the blood work would show
corresponding monoclonal myeloma protein peaks. |
