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Swollen Ankle for 4 months normal MRI/Bloodwork
My husband's (33 years old) ankle has been swollen since the end of August (you can not see the ankle, but the swelling is mostly isolated to the outside of his foot. There is no injury that he is aware of that has caused the swelling and pain. It is only the left ankle and it is always painful. About 6 constantly on his pain chart and more if it is lightly touched. Sitting, standing, and laying down are all painful. His blood work is normal and his MRI is normal except for the swelling. He is fit. The swelling has not gone down since August; it remains about the same. At times it is hot. Diabetes and arthritis run in his family.Orthopedist and family doctor have yet to diagnose. He has had chronic back pain for about 6 years (rib pain)  on his left side, normal MRI for that as well. This is also undiagnosed. I don't know if they could be related or what is causing the pain. Doctors give him anti inflammatories and talk about the possibility of a cortazon shot. He'd rather know what the problem is then just be given pain killers. Any help is much appreciated.
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875426 tn?1325532016
A)  Did they x-ray the foot (didn't see you mention that and MRI is better for soft tissue than for looking at the bones)?  If so, did it show signs of arthritis?

B)  I hope, with the family history of diabetes, they have run testing such as HbA1C, fasting blood sugar, glucose tolerance test?  

C)  So, they tested for gout and did they do blood cancer marker testing?  Have they taken a look at his blood calcium level?  

D) Did they rule out a blood clot, a thrombosis problem?

E) Did they do a doppler ultrasound of the left lower extremity to check circulation flow and to try to see if he has lymphedema?

F) Normally, both ankles swell with CHF, but did they do an echocardiogram to make sure heart looks okay?  Also, concerned the rib pain is on left side, the side of the heart.  Did they think that was costochondritis?  

G)If it is in the area of his ribs on the backside, did they take a look at his pancreas (behind stomach, left side)?

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Thank you so much responding. His x-ray showed a slight possibility of arthritis I believe

. I misunderstood his diabetes family history. His dad had type 2 non-hereditary adult diabetes.

They have not looked at his calcium levels, the doppler ultrasound, or done the cancer marker testing. I will let him know that those are items he may want to address when he meets with his primary doctor on Thursday.

He had an echo a few years ago during the beginning of his back pain, it came back normal. I was incorrect, his back/rib pain is on the right.

To the best of your knowledge do you know if there are any ailments that would connect the two symptoms? Thank you so much for your time and testimony it is greatly appreciated.
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875426 tn?1325532016
The reason I ask about blood calcium is because I have a parent w/MGUS, which in a small percentage of cases, can progress to multiple myeloma.  This is how I learned multiple myeloma can cause bone pain and high blood calcium can be a symptom as calcium leaves the bones.  It probably is not your husband's problem, but I'm not a doctor, so it won't hurt to ask about a blood calcium level.

A slight possibility of arthritis doesn't sound very definite.  

They did rule out gout then?  If you haven't already, you might try looking up the symptoms of gout, lymphedema, and thrombosis.  These can all affect one lower extremity.

The back/rib pain on the right- if it is toward the back of the rib cage on the right, have they taken a look at the liver?  If it is more at the flank, have they looked at his kidney on the right?  If it is more toward the middle on the right rib area, have they taken a look at the gall bladder?  If it is a localized tenderpoint when he probes with his fingers, have they considered whether it might be costochondritis?

I really don't know if the two are connected, but I hope these ideas might give the doctor' some encouragement to think more deeply about your husband's problems if he hasn't been trying that hard to come up with a definitive diagnosis (or more than one).


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Again, I appreciate you thoughtfulness and sharing. It's always good to keep doctors on their toes. :)
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875426 tn?1325532016
Please let me know what he finds out?  If it's been more than a week, please send me a private message in case I've deleted this thread from my watch list.  I'd be interested to find out what they learn.
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Thank you I will, He went to the doctors again, and they said the next step is additional blood work and a second opinion from an orthopedist. Thank you for your  commradery in this.
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875426 tn?1325532016
Hope you guys can find/have found an experienced orthopedist for evaluation!  When did he see the doctor and when are blood test results supposed to be back?  
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