No

possible cause Deep vein thrombosis (DVT), in which a blood clot blocks a vein in the leg, is likely, especially after a period of immobility. If not treated, a piece of clot may break off and then lodge in a blood vessel in a lung, blocking the blood flow.

action If your doctor suspects a DVT, you will be referred to hospital for tests such as Doppler ultrasound scanning (below) to examine the veins in the leg. Anticoagulant drugs will be prescribed, initially by injection, and may be needed for several weeks.

call your doctor now

Possible cause and action Certain drugs, such as calcium channel blockers, may cause swollen ankles as a side effect. Consult your doctor. Meanwhile, do not stop taking any of your prescribed drugs.

see your doctor within 24 hours possible cause Fluid retention as a result of a heart, kidney, or liver disorder is possible.

action Your doctor will probably arrange for tests, such as electrocardiography (p.203) and a chest X-ray (p.39). Initial treatment will often include diuretic drugs, but you will also need treatment for the underlying cause.

Possible cause and action Certain drugs, such as calcium channel blockers, may cause swollen ankles as a side effect. Consult your doctor. Meanwhile, do not stop taking any of your prescribed drugs.

Have you been sitting still for a long time, such as on an aeroplane flight, or standing for a long time?

Possible cause and action Varicose veins (swollen and distorted veins) are likely to have caused the swelling. Follow the self-help advice on coping with varicose veins (p.233). If your symptoms are severe, consult your doctor, who may suggest treatment (see Treating varicose veins, p.233).

possible cause Gravity causes accumulation of fluid in the tissues in these circumstances.

action Sitting with your feet raised should help the swelling go down. Walking or moving your feet regularly to exercise the calf muscles can help prevent fluid accumulating.

Consult your doctor if you are unable to make a diagnosis from this chart.

Doppler ultrasound scanning

In Doppler ultrasound scanning, high-frequency sound waves are used to assess the speed and direction of the flow In a blood vessel. Scans are usually performed to detect narrowing or blockages In an artery or vein. A transducer emits sound waves Into the blood vessels and picks up the echoes, then relays the data to a computer, which creates an Image of the blood flow.

During the procedure

A transducer emits sound waves and detects the echoes from the blood vessels to be examined.

Transducer is moved over skin above vessels

Transducer is moved over skin above vessels

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