Question
dr
I had my ankle fused 7 years ago very successfully I might add as I had severe arthritis. My ankle swells and I wear a compression stocking most of the time, for the last 8 months I have had a constant feeling on the top of the foot of the fused ankle, like something was dropped on it, very tender and stiff and there is swelling, yesterday I was getting these really wierd stinging pains in a vein on the same foot on top where the constant soreness is and every 10 minutes I would feel this stinging in the vein that would last around 8 seconds go away and come back like clockwork. the pain was severe enough that it woke me all nite and went on in 10 minute intervals for over 24 hours, I noticed then there was a swelling where the vein is and so I put ice on it, and the stinging sensation left me, but the top of my foot is still bruised feeling and stiff and sometimes my toes are numb.....can this be a sign of gout? or is this have something to do with my fusion?

Answer
Hi Tagi,

It doesn't sound like gout.  However, the symptoms can be associated with fusion of the foot/ankle.  The pain you describe sounds like nerve pain.  Often after a fusion, the nerves around the ankle get inflamed and entrapped and start causing the odd sensations.  This can simply be diagnosed by using a local anesthetic around certain nerves to see if you get relief.

I would start by having an x-ray and maybe even a CT scan to make sure that there have been no changes such as bone movement or fracture of bone or the screw.

If x-rays/CT are negative, I will typically try injections and some physical therapy.  Possibly immobilization or fabrication of a device known as an ankle foot orthosis.  I often put fusion patients into these orthoses anyway.

If I do determine that the problem is nerve in origin, I would consider Crysourgery for relief of the pain.  See my site below.

Hope that gets you started.  Good Luck.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com

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