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Q. My wife feels pain in and around the ankles after waking up in the morning. Why?

Answered by
Dr. Nupoor Acharya
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Sep 30, 2020 and last reviewed on: Feb 23, 2021

Hi doctor,

My wife has pain in and around the ankle on both feet after waking up in the morning. She gets some relief after having a walk for few steps within half an hour. She has a small lump-like swelling on the anterior side of the ankle. It got started before a year back with mild symptoms. But at present, it becomes worse day by day. If she sits for a long time, the pain recurs several times. Please suggest.

#

Hi,

Welcome to icliniq.com.

Your wife has symptoms of inflammatory arthritis. Ankle arthritis is seen in different conditions like rheumatoid arthritis, spondyloarthropathy, sarcoidosis, and poncet's disease. Please mention whether she has other symptoms such as pain in small joints of hands, backache, hip pain, fever, weight loss, and cough. A thorough history helps us to have a definitive diagnosis. She needs to do some investigations such as chest X-ray, X-ray of both feet, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), CBC (complete blood count), AST (aspartate transaminase), ALT (alanine transaminase), and KFT (kidney function tests). These are some basic investigations needed to be done. She needs to do some specific tests to confirm the diagnosis. For symptomatic relief, she can take tablet Naproxen 500 mg or Etoshine 60 mg (Etoricoxib).


Investigations to be done:

Your wife needs to do CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), KFT (kidney function test), AST (aspartate transaminase), ALT (alanine transaminase), chest X-ray, X-ray of both feet in anteroposterior view and lateral view and X-ray of pelvis.

Differential diagnosis:

Your wife can have spondyloarthropathy, rheumatoid arthritis, and sarcoidosis.

Treatment plan:

She can take tablet Naproxen 500 mg two times a day.


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