Fluid in the ankle

Fluid in the ankles or around the ankle joint is a common problem that causes pain and stiffness. It is usually a direct reaction of the body to an injury or inflammation. If the fluid does not develop suddenly but builds up slowly, it may be a sign of a rheumatic condition, reduced circulation, or a disorder of the lymphatic system.

How does fluid build up in the ankle?

Fluid in the ankle can occur, for example, due to a sprained or (partially) torn ankle ligament. The trigger for these injuries is the foot rolling inward, which damages the ligaments on the outside of the ankle.

Other possible reasons for fluid in the ankle are rheumatoid arthritis, gout, osteoarthritis or another inflammation. People who are overweight or who have diabetes (suikerziekte) have an increased risk of fluid in the ankle. Drainage of fluid is then limited due to reduced circulation. In addition, these individuals often move less, so the muscles do not 'pump away' the fluid.

Edema

Edema is a buildup of fluid in tissues and has various causes. This can occur when the blood vessels in the legs remove blood less efficiently to the heart. Due to gravity, the fluid accumulates in the lowest parts of the body, namely in the feet, ankles and lower legs. A well-known form of edema is fluid in the feet and ankles caused by warm weather or after a long flight.

Characteristics (symptoms) of fluid in the ankle

A swollen ankle is usually a symptom of an injury, not the injury itself. With an ankle sprain, in addition to the swelling there is immediate sharp pain and the ankle may bruise.

A swollen ankle due to joint inflammation as a result of rheumatoid arthritis or gout can be recognized by a very painful ankle that feels warm and may look red.

How is the cause of fluid in the ankle determined (diagnosed)?

It is important to identify the cause of the fluid in the ankle. To get a clear picture of the cause, the doctor or physical therapist will ask about how the symptoms started and perform several physical tests and examinations. With a sprain, there may be damage to the ankle ligaments. If in doubt, it may be necessary to take an X-ray or an MRI scan.

If joint inflammation is suspected, the doctor may decide to take blood or perform a joint aspiration. Using a needle, the doctor draws fluid from the ankle. The blood or fluid is then examined further. Any X-ray shows how severe the damage to the joint is.

Treatment of fluid in the ankle

As mentioned, it is important to clarify the cause first. In the meantime, it is wise to temporarily reduce (heavy) loading of the foot. Regular rest and elevating the leg help reduce pain and swelling. As soon as possible, gradually increase the load again.

If the fluid is the result of a sprain, it is advisable to visit a physical therapist. The therapist will provide exercises to strengthen the muscles around the ankle, increase mobility and train stability. This not only helps to reduce the symptoms, but also to prevent new injuries in the future.

With reduced circulation, or if the fluid is a result of osteoarthritis, a support stocking or compression stocking can provide relief. These promote better drainage of the accumulated fluid.