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I have a pt that is mystifying the life out of me?

19 yr old female C/O Left ankle swelling for approx 1 year duration. I have not observed the swelling, but pt reports it can happen weightbearing and non weightbearing? Generally it is worse after a day standing at work, however there is no pain and it takes approx 1 day to subside. There is no history of injury or trauma, the patient also thinks that the problem got worse following a flight a home from Mexico? There doesn't appear to be any neuro/vascular deficit, and biomechanically there is nothing adverse to report. She has had every blood test under the sun done - twice in some instances all have come back negative?

Any thoughts would be welcome?

cheers Bartypb

 

Bartypb can you be alittle more specific where the swelling is? ie plantar to lateral malleolar or anterior to lateral malleolar etc.


Is there swelling in the region of the sinus tarsi?

Any palpation pain ?

 

I realised it was a little vague in description, but it is generally all around the lateral malleolus, I have not seen it in its swollen state, but the patient was describing it as general lateral ankle swelling wich can occasionally extend to anterior ankle / sinus tarsae. There is no pain anywhere on paplation or taking the ankle and STJ through range, there is no restiction or poor quality in joint movement and all ligament tests are normal?

cheers Bartypb

 

Bartypd,


Have you got the patient to wear support socks for a couple of days to see what happens ?