Swollen Foot/Ankle, Doctors clueless

[XanderB]

A week ago, I noticed something strange occur.  On that Saturday, I woke up and noticed that the top of my right foot was swollen.  I didn't notice anything unusual, no cuts or bruises.  Then Sunday, I woke up to find my foot even more swollen and my ankle swelling as well, as well as the ankle turned a bright redish/purple.  This occurred while I was sleeping.  I went in to see my primary and he couldn't figure it out.  He started with gout, but I've had that before and have no pain.  He then thought Cellulitis, but there was nothing to indicate that either.  So he put me on an anti-inflammatory and antibiotic and said to come back in a week.  After a week of treatment, my foot/ankle have gone unchanged.  Today they did a blood test for electrolytes, blood count, cholesterol, and all that.  Everything came back normal.  So they gave me a prescription for something that is supposed to get rid of the fluid buildup, but once again they had no answers beyond "take these meds and see us in a week".  

The only change that I've noticed is that my ankle is starting to get little tinges of pain when I flex it in a certain direction.  Beyond that, I can walk on the foot without pain.  The only thing that is uncomfortable is the fact that I have to wear sandals because my shoes won't fit over my foot (the top of the foot is indeed that swollen).  The foot itself is not discolored in any way, it's only the ankle.  

So any possible ideas would be appreciated.  I hate thinking that going through all this isn't getting to the issue at hand and I'm worried that if I keep walking around on it I'm going to cause something else to go wrong.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
A single ankle and foot can swell in gout, rheumatoid arthritis, deep vein thrombosis, trauma, fracture, ligament tear, tendonitis, bursitis or ankle or foot strain. It can also be due to localized infection of the skin above and not be related to the joint.  X-rays will be negative for all causes except fracture. MRI of the joint may be required to locate the cause. Since there is a discoloration too, it could be deep vein thrombosis, which can be diagnosed by duplex ultrasound or color dopplar. It is difficult to comment beyond this at this stage.
I think you should discuss these possibilities with your doctor. It is difficult to comment beyond this without examining. A comprehensive investigation is required keeping all the points in mind.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!

[XanderB]

As an update, the HCTZ that the doctor put me on to get rid of the fluids appears to be working (although slowly).  The problem is that my ankle is now in some interesting pain.  It's still purple and swollen (though there's not much fluid left), and although I can walk on the foot without any issues, if I push down on the ball of my foot I get a sharp poking pain on the outer portion of my ankle.  Which makes me wonder if I did indeed do something to it originally.

[Pamelaone]

I would have your doctors begin the medical process of finding out if you have R.S.D. or now called C.R.P.S. and hopefuully if you do have it then the best that can happen is you will experience the pain some day will be bad and other days no one will be able to touch you. Or you could check out a massage therapist for lymph nodes that are not circulating as it should. Best of luck.

[XanderB]

They have not ordered to have one done.  I asked if that would be something to look into, but they said that I would notice if I had a broken bone.

[Waseem148]

I'm not sure if you have an XRay done of your foot/ankle?