The ankle is a large joint made up of three bones:
- The shin bone (tibia)
- The thinner bone running next to the shin bone (fibula)
- A foot bone that sits above the heel bone (talus)
The bony bumps (or protrusions) seen and felt on the ankle have their own names:
- The medial malleolus, felt on the inside of your ankle is part of the tibia's base
- The posterior malleolus, felt on the back of your ankle is also part of the tibia's base
- The lateral malleolus, felt on the outside of your ankle is the low end of the fibula
The ankle joint allows up-and-down movement of the foot. The subtalar joint sits below the ankle joint, and allows side-to-side motion of the foot. Numerous ligaments (made of tough, moveable tissue) surround the true ankle and subtalar joints, binding the bones of the leg to each other and to those of the foot.
Ankle Conditions
- Sprained ankle: Damage to one of the ligaments in the ankle, usually from an accidental twist or turn of the foot. Rehabilitation can prevent pain and swelling from becoming a long-term problem.
- High ankle sprain: The ligament joining the two bones of the lower leg (tibia and fibula), called the syndesmotic ligament, is injured. A high ankle sprain causes pain and swelling similar to a true ankle sprain, but can take longer to heal.
- Ankle fracture: A break in any of the three bones in the ankle. Most commonly, the bones of the lower leg (tibia or fibula) is fractured.
- Ankle arthritis: While it’s not common, osteoarthritis, the most common form of arthritis, can affect the ankle.
- Rheumatoid arthritis: An autoimmune form of arthritis in which the body attacks joint tissue, causing inflammation, pain, and swelling. Any joint may be affected by rheumatoid arthritis, including the ankle.
- Gout: A form of arthritis in which crystals periodically deposit in joints, causing severe pain and swelling. The ankle may sometimes be affected by gout.
- Psoriatic arthritis: This form of arthritis, which causes swelling and pain, is associated with the skin condition psoriasis. Many joints, including the ankle, may be affected by psoriasis.
- Septic arthritis: Caused by bacterial infections that may occur in the ankle, this form of arthritis develops quickly, causing severe pain, swelling, fever, and difficulty moving the ankle.
Ankle Tests
- Physical examination: A health-care provider's examination of the ankle may identify whether an ankle fracture, sprain, or another condition is present.
- Ankle X-ray: An X-ray film of the ankle is most commonly used to determine a fracture, arthritis, or other problems.
- Stress X-ray: A doctor puts pressure on an injured ankle and takes an X-ray film. Also called a stress film or a stress test, this may uncover ankle problems unseen on regular X-rays.
- Magnetic resonance imaging (MRI scan): An MRI scanner uses a high-powered magnet and a computer to create high-resolution images of the ankle.
Ankle Treatments
- RICE therapy: RICE stands for Rest, Ice, Compression (as with an athletic bandage), and Elevation. RICE therapy is good initial treatment for most ankle injuries.
- Pain medicines: Over-the-counter or prescription pain relievers such as acetaminophen (Tylenol), ibuprofen (Motrin), and naproxen (Aleve) can ease most ankle pain.
- Cortisone injections: Injecting cortisone into the ankle can help with some forms of ankle arthritis. Cortisone suppresses inflammation in the ankle joint, reducing swelling and pain.
- Ankle immobilization: Immobilizing the ankle (usually with a cast) is necessary for most ankle fractures. Some health-care providers believe immobilization may help ankle sprains as well.
- Ankle surgery: Surgery may be required for many serious ankle conditions. In general, ankle surgery is performed in order to make the ankle more stable. Various techniques are used to keep the ankle bones in place.
- Syndesmotic screw: A surgeon places a screw connecting the bones of the lower leg. This keeps the bones together, giving a high ankle sprain time to heal. Once healed, the screw is removed.
- Ankle arthroscopic surgery: Ankle surgery using tools inserted through small incisions in the ankle. One of the tools, an endoscope, allows a surgeon to view the inside of the ankle joint on a video screen.
- Ankle fusion surgery: Surgery to fuse the bones of the ankle together, limiting movement in the ankle. Ankle fusion surgery can relieve the pain of severe ankle arthritis
- Ankle replacement surgery: Although some surgeons perform ankle replacement surgery, the results are generally poor, compared to knee replacement surgery. Watch the video.
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