The patient is my mother, age 58, with chronic psoriasis which is under control. She has been having right foot swelling for the past two months. Her left feet is normal. Initial diagnosis at local clinics was an infection and severe arthritis. She was put on anti-inflammatory, antibiotics and antifungal cream. There was some symptomatic relief but the swelling did not resolve. X-ray of her feet was reported mild bone degeneration. Otherwise no other significant pathology. She was admitted to the hospital two weeks ago. FBS, ESR and uric acid were reported as normal. She was put on cryotherapy and physiotherapy. She has been discharged to home now.
Her condition is slightly better but the pain and swelling did not resolve completely. She has a few more cycles of physiotherapy to follow. She remembers spraining her right feet two weeks before the entire episode of the swelling started. As she did not feel any pain or discomfort immediately after the incident, she just ignored the sprain incident. She also had a hysterectomy done two years ago due to calcified fibroids which caused occasional leg swelling at that time. Please advise what has to be done.
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I have reviewed your health query and can understand how worried you are about your mother.
This seems to be due to the foot sprain she inflicted in the recent past (attachment removed to protect patient identity). She might have caused a damage to the soft tissues of the right foot. She has got swelling of the foot due to local inflammation of the soft tissues of the foot. She should keep up with the physical therapy and cryotherapy as this would assist her to relieve this inflammation. She should also keep taking medications as these medications not only relieve the pain but also inflammation.
She should keep the right leg up while laying down and should not hang the leg down while sitting. This change in leg position would help a lot as this avoids pooling of blood down due to gravity. Pooling of blood leads to more swelling in feet. There is nothing more you need to do in this situation. Just keep up with the cryotherapy and physical therapy. It would take her back to normal life very soon.
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