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 traumatic injury and often develop gradually. A thorough evaluation by a doctor with blood testing can be necessary for ultimate diagnosis. 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.
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.
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.