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Non pitting edema on top of right foot and non weight bearing pain.

by Eileen
(Dallas, Texas)

Hi, My right ankle was reconstructed about 30 years ago after the bone crumbled. As the Ortho said, it was like a fractured egg shell after so many fractures to it that were diagnosed as sprains by ER Doctors and simple Xrays instead of the hairline fractures to the inside of the ankle bone that they were. About 8 years ago I started getting these episodes where the top of my foot will actually retain fluid so badly that it puffs up and out over what ever I am wearing that day as a shoe (always flat shoe wear). There have been a few episodes it has been a pitting edema, but more often not and on ocassion it will actually break open in a very small area though nothing leaks from it. It almost always swells to the point that my calf will become hard as well and my foot is shiny on top. Also, I get these red spots/blotches under the skin that are hot to the touch just above the ankle on the inside of the leg. I've been to so many Orthopods over the years and I have heard, RSD, Tendonitis, needs to be Reconstucted again, Strep G and the list goes on. I was perscribed a 3D boot and it did seem to help at times, of course pain meds help, but no one can live on those. They gave me diuretics which didn't help, thought it was my kidneys, it wasn't, ugh, I have been a regular guinea pig. Oddly enough, though the Doctors are loathe to do it, long term antibiotics have helped a couple of times. The RSD meds did not do a thing and I am alergic to many steroids. I am not diabetic, I have low/normal blood pressure at the age of 48 and I am generally rather healthy otherwise, thought I do get re ocurring ear infections/allergies/sinus pain since moving to Texas, thought I take nothing for it, just let it run its course. I'm frustrated and beyond at the moment as I am having yet another episode at the moment and nothing seems to work. I have taken Ibuprofen to the extreme (600 mg a minimum of 4 times a day, this does help a bit with the pain and at least I can bear weight a bit with that, but I quit yesterday as it is hurting my stomach. I have iced it, have soaked it in epsons salt, have elovated it and still I can't bear weight. The pain is so bad when I step down I feel as though my ankle bone is going to split in half. Oh yes and sometimes it goes numb. I no longer have insurance, so I cannot run off to yet another Doctor. Any ideas? I quite frankly am at the end of my rope with it all and am due back at work in a couple days.







Hi Eileen,
A complicated case (even tho well described by you) cannot be properly evaluated by me in this forum.
I would think it would not be far fetched to have figured that one day you would have problems with the ankle due to the injury and the amount of surgery necessary to correct it.
Based on your history I would think this is more of a mechanical problem (the way you walk and the trauma from the surgery) rather than some sort of disease process.
Have you tried just walking with the foot and ankle wrapped in an effort to stabilize your ankle function, or lack thereof and to keep the edema down? I know it sounds like a simple answer to a complex problem, but that might be the only way you can reduce the symptoms.
Marc Mitnick DPM

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