Ankle Pain and Tendinitis (cont.)
What diseases and conditions can cause ankle
pain, and how are they treated?
Inflammatory types of arthritis (inflammation of
the joint) that can involve the ankle area include rheumatoid
arthritis, reactive arthritis, gouty arthritis, ankylosing spondylitis,
and psoriatic arthritis, among others. They generally are not
induced by trauma injury and develop gradually. These types of
arthritis are associated with pain, swelling, stiffness, redness,
and warmth in the involved area. These diseases each have unique
management as described elsewhere. For further information, please
refer to the following articles:
Rheumatoid Arthritis,
Reactive Arthritis,
Gout,
Ankylosing Spondylitis,
and Psoriatic Arthritis.
Other conditions of the ankle which can cause ankle
pain include tarsal tunnel syndrome. This is a result of nerve
compression at the ankle as the nerve passes under the normal
supportive band surrounding the ankle called the flexor retinaculum.
Tarsal tunnel syndrome is described elsewhere. For further
information, please read the Tarsal Tunnel Syndrome article.
Infections of the ankle joint are rare. They most
commonly occur as a result of bacteria being introduced into the ankle joint
through puncture wounds or trauma. They also occur with a breakdown of the skin
over the ankle as a result of ulcerations or abrasions. Patients with impaired
immune systems such as those with AIDS,
or other immune diseases, are at an increased risk of
infections in the joints, including the ankle. Also, patients with
diabetes or those who take cortisone medications have an increased
risk for bacterial infections of the joints. Bacterial joint
infections
are serious and require drainage and antibiotics, usually
intravenously.
It is possible to develop viral infections of the
ankle joints. In an isolated joint, such as the ankle, this most
commonly occurs in children and is referred to as "toxic
synovitis." It results in temporary joint inflammation and
can be first noticed as subtle limping in the child. It is benign
and resolves on its own with only symptomatic treatment, such as
acetaminophen (Tylenol), for relief of pain.
- The ankle is a "hinged" joint.
- The severity of ankle sprains ranges from mild (which
can resolve within 24 hours) to severe (which can require surgical repair).
- Tendinitis of the ankle can be caused by trauma
or inflammatory arthritis.
References: Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
Last Editorial Review: 3/10/2008
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