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Dr. Hive...I woke up with a sore, swollen ankle


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And have NO idea why. How on earth does one injure an ankle in their sleep? I woke up and noticed as I was walking that it felt a bit unstable/stiff/sore....I was walking and it feels like it wants to collapse to the outside. Whatver, I'm obese and getting older and figured heck, I'm going to get some stiffness in the morning, whatever. I made breakfast, puttered on the computer, and cleaned the bathroom up. (ok, and was on the computer a bunch). I just happened to stretch my legs and put them up, and noticed it is quite swollen!! Ok, this is not in my head, it isn't normal stiffness...those wouldn't cause swelling!

 

So, what on earth? The swelling is in front of my ankle bone, on the outside. Any thoughts? Anything to worry about? I took some advil, and honestly it doesn't hurt that bad. I have arthritis in my fingers and toes sometimes, and it is not as bad as those. Just a bit warm feeling at rest, and weak/sore when walking.

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Ok, after some ibuprofen it seems less swollen. I felt around, and there is a bit of a lump in front of the ankle bone, like a knot I guess? I do get up with the toddler during the night/early morning, so maybe I did something to it and just don't remember? Or, we moved the furniture around and I was nursing her last night in a different spot...I had my feet propped up on the ottoman and just now I did it again and that definitley puts strain on my ankle and isn't comfortable. Maybe doing that did something to it?

 

Seriously didn't need to worry about this. I was up late with bad ovulation pain and cramping, now this! It honestly doesn't hurt that much, so I'm going to keep an eye on it, check to make sure circulation is good, and that it is not getting worse. If it gets worse I'll call the doctor.

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Yikes...would that happen in the ankle? It honestly seems like i sprained my ankle a bit, I just don't remember doing it.

 

First, if it is improving with treatment and swelling is subsiding then is not a blood clot. So don't panic, but I was concerned that you be cautious with unexplained swelling. On the other hand I don't want you hanging around for days or weeks with unexplained swelling in your ankle because they symptom seems mild.

 

If it is a blood clot the risk is a pulmonary embolism where the clot comes free of where it is now, in your leg, and goes to the lungs or heart. Death rate for that is 30%. You'd want to be treated with blood thinners. I'm told that sometimes the limb with the blood clot will feel colder than other limbs. (Note: you won't have embolism symptoms unless the clot has traveled.)

 

Also, blood clots with no explanation will mean testing you for some forms of cancer as they are linked to that.

 

SO if it gets better, I would not worry, but if it continues check in with a doctor. And if you start having shortness of breath, go!

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Death rate for that is 30%.
While blood clots are nothing to mess around with, that is way overestimated.

Link

Much of the literature on pulmonary embolism that is commonly referenced by emergency

physicians begins with statistics concerning how often the diagnosis is missed and the lethality of

pulmonary embolism if undiagnosed and untreated. It is likely that many emergency physicians

continue to pursue an aggressive diagnostic strategy even in low-risk patients because of concerns

about the potential for poor patient outcome and the medicolegal consequences of a missed

diagnosis. The believed and often-quoted mortality and recurrence rates for untreated or missed

pulmonary embolism are 26% to 30%. However, these figures originate from investigations that have

little relevance to modern emergency medicine, which include studies dating to the 1940s, many of

which have significant methodologic pitfalls. These data are also based primarily on either inpatient

or autopsy populations, neither of which is representative of patients treated in the emergency

department (ED). Analysis of untreated or missed pulmonary embolism in ambulatory patients

reveals mortality and recurrence rates of less than 5%. This article discusses the background of

commonly quoted pulmonary embolism statistics and highlights the need for future investigations

enrolling ED patients that focus on disease outcome in this population. [Ann Emerg Med.

2005;45:302-310.]

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