Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

Why Are My Ankle and Lower Leg Swollen?

Thursday, 18 February 2010 08:53 AM

Question: My ankle and lower leg have been swollen for over a year now, but I'm not in any pain. I also have fluid retention. The doctor put me on hydrochlorot, but it didn’t help. My skin is very dry, plus I also have many varicose veins around the sides of my ankle and foot.

Dr. Hibberd's Answer:

The presence of varicose veins with leg edema suggests you have peripheral venous insufficiency — some of the perforating veins connecting to your deep venous system are allowing pressure to back up into your superficial veins.

Perhaps there is deep venous obstruction, or perhaps the valves have been damaged. Perhaps you have a different type of swelling called interstitial edema that is not diuretic sensitive, or perhaps you have edema seen with lymphatic obstruction called lymphedema that is also resistant to diuretics (water pills).

Always have varicose veins or peripheral swelling completely evaluated so specific treatment may prevent limb and circulatory complications. Proper evaluation of peripheral edema includes a full assessment of your heart, lungs, thyroid, liver, kidney, colon, and pelvic area for signs of obstruction, as well as evaluation of pelvis, thigh, and knee/leg for signs of venous obstruction, tumor, or clot.

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