Fluid in the ankle

Fluid in the ankles or around the ankle joint is a common problem and brings pain and stiffness with it. Usually this is a direct reaction of the body to an injury or inflammation. If the fluid does not develop suddenly but gradually, this can be a sign of rheumatoid arthritis, poor circulation or a disorder of the lymphatic system.

How does fluid in the ankle occur?

Fluid in the ankle occurs, for example, due to a stretched or (partially) torn ankle ligament. The trigger for these injuries is the foot turning inwards, whereby damage occurs to 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 have diabetes also have an increased risk of fluid in the ankle. The drainage of fluid is then limited due to reduced circulation. Moreover, these people often move less, so that the muscles do not 'pump away' the fluid.

Oedema

Oedema is an accumulation of fluid in tissues and has various causes. This can occur if the blood vessels in the legs do not drain the blood well back to the heart. The fluid accumulates due to gravity in the lowest-lying places in the body, namely in the feet, ankles and lower legs. A well-known form of oedema is fluid in the feet and ankles due to hot weather or after a long flight.

Characteristics (symptoms) of fluid in the ankle

A swollen ankle is usually a sign of an injury, not the injury itself. With an ankle sprain, besides the fluid, there is also immediate sharp pain and the ankle can turn blue.

A swollen ankle due to a joint inflammation as a result of rheumatoid arthritis or gout is recognised by a very painful ankle that feels warm and may have a red colour.

How is the cause of fluid in the ankle diagnosed?

It is important to determine the cause of the fluid in the ankle. To get a clear picture of the cause, the doctor or physiotherapist asks about the onset of the complaints and several physical tests and examinations follow. With a sprain there may be damage to the ankle ligaments. In case of doubt it may be necessary to take an X-ray or an MRI scan.

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

Treatment of fluid in the ankle

As said, it is important that the cause is clear first. In the meantime it is sensible to put less (heavy) load on the foot temporarily. Taking regular rest and elevating the leg help to reduce the pain and swelling. As soon as possible it is good to slowly build up the load again.

If the fluid is the result of a sprain, it is advisable to go to the physiotherapist. They give exercises to strengthen the muscles around the ankle, increase mobility and train stability. This is not only good to reduce the complaints, 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 ensure better drainage of the accumulated fluid.