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Mystery Ankle Pain

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I have has severe ankle pain for roughly 18 months. The whole ankle joint is swollen on both my left and right ankles and on parts of the bridge of my foot. At first it was just a burning pain when I walked too much but now it is every time I walk. The pain feels like bruning, the joint seizes and I can't move my feet after. The joint feels like its going to pop out and just recently I have been getting sharp pains which last 10-15 minutes at a time then go and then come back again 5 minutes later. I have had an mri, tried physio, been on meds but nothings working and the doctors at the hosptial cant find a cause. They are going to give me injections into the joint but can't say whats wrong with me or whether it'll work. Does anyone have any idea what it could be??
Btw I have had blood tests for arthritis but nothing.
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replied February 6th, 2012
Especially eHealthy
Bex474,

Well, when you stated that the ankles and instep swell and have a burning sensation when walking, the first thing that came to mind was some sort of peripheral neuropathy, possibly causing a Charcot joint. The most common cause of these is a metabolic disorder, such as diabetes or thyroid disorder. But, you have most likely been checked for those.

You also stated that the joint seizes up and feels like it is going to pop, that is commonly caused by some sort of soft tissue impingement. These can also cause diffuse intraatricular swelling. It is not uncommon to develop a meniscoid lesion in the anterior talofibular joint. The first one described was by Dr. Wolin and carries his name - a Wolin lesion. But, these are easily picked up by MRI of the ankle.

OCD, or osteochondral defect in the talus can cause swelling and sensation of catching/popping with pain in the joint. But, again, these are usually picked up on plain x-rays, and definitely on an MRI.


One thing, if your MRI did not show any swelling, be it edema outside the joint or an intraarticular effusion, then there wasn't any, at that time. Swelling would have shown up on an MRI like christmas tree lights. So, if the MRI was done when you did not have any swelling, you may need to have it repeated.

However, if you have intraarticular swelling (called an effusion), then it might be helpful to obtain some of that fluid to look at under the microscope. That can be done at the same time that the cortisone injection is done. Gout (uric acid crystals), pseudogout (CPPD - calcium pyrophosphate dihydrate), and some other crystalline arthropathies can be determined by looking at the synovial fluid.


But, it is very difficult to determine exactly what is going on when the studies are not very helpful. Sometimes, the condition has to be treated symptomatically, until a diagnosis can be determined. And, that can take a long time, in some cases. All you can do is keep track of your symptoms, what caused them, what makes them better/worse, etc and keep seeing the physician on a regular basis. Specialist consultations are helpful also, such a rheumotology, immunology, and orthopedics.

Good luck. Hope you find the cause of your problem.
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