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Possible causes Gout, in which the waste product uric acid forms crystals in a joint, causing inflammation, is the most likely cause of your symptoms. An infection within the joint is also a possibility.

action Your doctor will examine you, and may arrange for a blood test and for a sample of fluid to be taken from the joint and examined. If you have gout, you will be prescribed nonsteroidal anti-inflammatory drugs. If the symptoms recur, you may need long-term drug treatment to reduce the amount of uric acid in the body. If the joint is infected, you will need treatment with antibiotics, in hospital initially.

possible cause Osteoarthritis, a progressive condition in which cartilage covering the ends of the bones within a joint is slowly destroyed, is a possibility. This condition is particularly likely if you are over 50, if the joint has been damaged previously, or if you are overweight. Consult your doctor.

action Your doctor will examine you and may arrange for you to have blood tests and an X-ray (p.39) to confirm the diagnosis. Over-the-counter painkillers should help to relieve your symptoms. If you are also overweight, it will help to lose weight. In some cases, your doctor may refer you for physiotherapy to strengthen the muscles around the joint. In severe cases, a joint replacement (p.229) may be needed.

Possible causes A fracture or dislocation causing bleeding into the knee joint, or a serious injury to the muscles, ligaments, or cartilage of the knee is possible.

action You will probably need to have an X-ray (p.39) to discover the type and extent of the damage. Sometimes an operation is needed to reposition bones. Depending on the nature of the injury, you may need to wear a plaster cast or a firm bandage.

Arthroscopy

During the procedure

An arthroscope and a probe are inserted into the joint, allowing the surgeon to inspect the joint. The probe can be used to manipulate the cartilage and improve the view.

In arthroscopy, the Inside of a joint, such as the knee, is inspected using a viewing instrument called an arthroscope. The procedure is usually performed under a general anaesthetic. The arthroscope is inserted into the joint through a small incision in the skin, and the view from the arthroscope is displayed on a screen. Very small instruments can then be passed down through the arthroscope or inserted into the joint through other small incisions. Guided by the view on the monitor, the surgeon is able to carry out procedures such as repairing torn ligaments or removing damaged cartilage. Fluid passed down a tube is then used to wash away the debris from within the operating area.

Vieiu of Monitor

J15> Swollen ankles

If you are pregnant, see chart 146, Swollen ankles in pregnancy (p.283). For painful swelling of one or both ankles, see chart 110, Painful joints (p.228). Painless swelling of the ankles is most often caused by fluid accumulating in the tissues after long periods of sitting or standing still. It is also common in pregnancy due to increased pressure on blood vessels in the abdomen. However, occasionally, swelling of the ankles may be due to a potentially serious heart, liver, or kidney disorder. If you frequently have swollen ankles, consult your doctor.

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