Swollen ankle for the past 8 years

For the past 8 years I have bounced between orthopedics and rheumatology to determine what was causing the swelling and pain in my ankle. Since the onset my ankle joint has deteriorated significantly. I was originally told I had a minor fracture and given an elastic brace, told to come back if not better and then referred to a rheumatologist who tested me for RA but the results were inconclusive but she thought I exhibited systems so put be on Methotrexate. Was on this for 6mos and no improvement so I took myself off it and went back 3 mos later to discuss. The rheumatologist agreed with me that I did not have RA and referrred me back to orthopedics. After 5 years and 2 MRI's and multiple xrays I still have not been able to find out what is wrong. Even went to a vascular doctor who said the problem was not circulation. I now decided to go back to the rheumatologist to see if it is psoriactic arthritis. I only have a few of the symtoms and no psoriasis. I am hoping that it is psoricatic arthritis so treatment can be started to stop the inflamatory swelling. Once that is under control the next step is to have surgery to clean out the ankle deterioration. Has anyone else experienced this problem? Any suggestions would be appreciated.

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I couldn't tell you the number of times I was JUST walking along like always, and BANG ~ Swollen, sprained, bruised ankle. Same thing happened multiple times with my lower back & later my neck. The number of things that went unexplained is amazing.

When I was asked the 'typical' questions about RA and if I had this or that... I was like, I have other medical issues that could explaine some of it so I didn't think much of it. I was diagnosed with a connective tissue disorder first. And recently with sero-negitive (Doesn't show up in the RF factor) rheumatoid arthritis.

I am not on RA medications that has been a lifesaver. BUT still have general swelling that has not gone down. I also take a water pill to take most of it away...

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Thanks for the reply. So you also have a swollen ankle? What do they think is causing the inflamation? As much as I hate being on medications like those prescribed for RA and Psoriatic A I am concerned that my good ankle will soon get inflammed and then deteriorate as well.

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I don't know if your swelling is like an edema, fluid retention.

I had 2 series of fluid retention; one from a new BP med and the

other "edema" after hip replacement surgery last year.

Both times I upped the dosage of Grapessed Extract for a while and the edema is GONE.

I've been taking GSExtract for 16 yrs and it addresses so many issues.

I do have a sore ankle from pain and OA issues, pain coming from the hip replacement and back stuff, but NO MORE edema. I wear an ankle3 brace now too.

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My feet & ankles was so swollen I walked around without socks because the socks dug into the skin to the point of causing additional pain. I am in Minnesota where we get nasty cold winters with ALOT of snow. I walked around in my extra wide sneakers with no socks all last winter.

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Thanks for the grapeseed extract suggestion. I have tried taking flax seed to reduce swelling but it didn't really help so perhaps the grapeseed extract might.

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Well after 7 yrs or more of not knowing what the swelling of my ankle and consequent joint damage was caused by, my Rheumatologist has determined it must be a non specific rheumatoid problem - not RA and not PA- so she talked me into starting Methotrexate injections. I was on a oral metho 5 yrs ago for about 6 mos with no results so that was when she determined I didn't have RA and was sent back to Orthopaedics. I questioned why Metho again and now injections and she is saying that the injections will work better and also that most insurance will not cover Enbrel or other treatments until Metho has failed. Has anyone else been told this?
I am concerned about being on Metho as I know it is a form of chemo and has many side effects. Since the swelling is confined to only one ankle I am concerned that, in addition to further detoriation of that ankle, it could also spread to other joints so that is why I agreed to taking the metho injections.
Does anyone take Naprelan? I relative of mine has been on it for years to treat her RA and doesn't seem to have any significant side effects and also it is taken orally.

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Do you have problems with other joints? You don't say anything about that but I think it is critical. If you have had problems with just one ankle for 8 years, I doubt that it is a rheumatoid problem because you would expect other joints to become involved over time. If I were you, I would go to a major hospital like the Mayo Clinic or Cleveland Clinic for a full workup to determine what is wrong. They will have several doctors collaborate to figure out the problem instead of you bouncing from one specialist to another with no communication between them. JMHO.

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Thanks JMHO, I go to the Lahey Clinic in Ma. which has a very good reputation. The swelling is in my right ankle only and because the origin of the swelling has not been determined I have not been on any treatment other than a cordisone shot a few months back that definitely helped but was short lived. I have minor aches in other extremities which I attribute to the aging process but nothing significant and a cause for concern. RA doctor told me it is not RA but said there are many different type of auto immune diseases that are similar.

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It isn't a matter of reputation. There are wonderful docs and wonderful hospitals all over the US. But at places like Mayo and Cleveland Clinic, they collaborate immediately, not send you from one specialist to another. The doctors in different specialties actually talk to one another while you are there. Patients travel long distances to go to these places so it isn't a matter of see Dr. A then wait 2 weeks to see Dr. B. It is a completely different way of working.

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ok, I understand now. Well for me I guess I should give the Methotrexate and chance and if no results then decide on a new course of action. Thanks for your suggestion.

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Have you had a needle aspiration done to study the fluid around the actual joint? I think I'd ask someone to do that. You may have some kind of bacteria infection.

Or maybe you have gout in your ankle. The big toe isn't the only joint that gout can affect.

I'd ask that someone study the synovial fluid right away. Especially before you start taking dangerous medications for a disease that you probably don't have.

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Tthanks Roseta,
I did have the needle aspiration done about 6 mos ago and while there was alot of fluid it tested negative for infection, gout and other possibilities which is why my Orthopaedic doctor had me to back to RA. He actually remove fluid twice and also gave me a Cortisone shot that worked great for a week and then the swelling started returning. My RA feels it is one of those strange auto immune problems that they can't label RS or PA to it since the tests didn't indicate it. She actually said there is no test to determine PA and if I had any Psoraisis she would think that is what I have. She also said I could eventually develope Psoraisis if I do indeed have PA.

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I'm sure there's a doctor out there who's seen this before and has the answer for you.

Perhaps you could get opinions from specialists if you are willing to send your test results and diagnosis histories to specialists at teaching hospitals or maybe even the Cleveland Clinic. Basically having the doctors with the most experience and vast knowledge sources.

I was amazed at the skill of the doctors there when I had my thyroidectomy and thymectomy surgery. I wouldn't hesitate to go there again, and since my symptoms seem to puzzle my doctors I may end up back in Cleveland to find answers to what is causing my increasing disability.

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