This page about ankle gout was last reviewed, or updated, on 8 January 2017.
There was a gout sufferer who thought for year that he had a sprained ankle. Then he found out it was gout. There was another gout in the ankle sufferer who was diagnosed with cellulitis. It was re-diagnosed as gout. Finally, the original verdict was re-confirmed as the correct one.
In cellulitis, the skin becomes hot, swollen and reddish, and you might have a fever. You know what that sounds like. But it's caused by a bacterial infection on the skin and in the tissues under it, not by uric acid turning into gout crystals. Ankle gout could feel like a sprain, or a twist, or a broken ankle. Ankle gout can also be confused with pseudo gout and arthritis pain.
That quite a long list of injuries or medical problems with some similar symptoms, so it's worth repeating that the premier test for gout, which usually proves it, is the joint aspiration test (aka arthrocentesis). Click to the gout symptoms page to read how it's done. If you suspect gout, this is the test to have done. But, sorry to say, you may have to hunt around for a medical establishment that has the necessary polarising (polarizing) microscope.
The best kind of doctor to see is a rheumatologist, not necessarily your general practitioner (G.P.) or primary care physician (P.C.P.). A rheumatologist should have the microscope, and the user experience to spot the needle shaped gout crystals. But collecting enough synovial fluid out of the affected joint to do the test can be difficult.
Ankle gout Symptoms
Remember, when you're trying to decide if it's gout, that gout foot pain is very very painful, probably much more so than the above mentioned injuries and maladies. If there's no real pain it's not gout. Note too what gout looks like - it's red or purple, shiny, feels very sore and tender, and is inflamed/swollen. If it's a gout flare the maximum inflammation is reached in 12 - 24 hours.
Ankle gout - a mild case
There is a tendency for gout to attack in areas where there has been a previous non-gout injury. A single joint will probably be attacked. If's there's similar symptoms in two joints simultaneously it's probably not gout. You will almost certainly have high uric acid, above 7.0 mg/dL, (men) and 6.0 mg/dL, (women).
Despite the single joint tendency when gout attacks the ankle it could be the left or right or both, even at the same time, just like a big toe gout attack.
The pain can be felt across the whole ankle or just on/by the joint. The ankle or the foot could swell to double normal size, or it may not. It might cause leg cramps and it might travel up the shin. The ankle will probably stiffen, so you won't have your usual ability to bend or rotate it.
You can see from this, that diagnosing gout quickly isn't necessarily easy, but in time it becomes clear.
MSU gout crystals seem to prefer joints, and their synovial fluid, but they can crystallise (crystallize) in tissues, tendons, ligaments, cartilage and even organs such as the kidneys. Heel gout, instep gout, foot arch gout and of course big toe gout - all these are kinds of foot gout that gout sufferers can unfortunately get. However, gout doesn't often spread around the whole foot, although it may head for one these areas, especially the big toes. But ankle gout pain might be felt across the whole foot, leaving sufferers to hobble around on crutches, if they feel well enough and are not bed-ridden.
Foot & ankle tophi
Beware the arrival of tophi
Or a tophus (singular) or tophi (plural) can develop from a single MSU gout crystal deposit and in the same places - cartilage, tendons, ligaments; a tophus (tophi) erodes bones, and can eventually destroy joints. A tophus stiffens joints, any joint where it develops, and the ankle is no exception. But you'll be glad to know that this can take years, so you have plenty of time. However, if gout is not controlled, this is what can eventually happen.
Protection and help
If you get ankle gout, protect the big toes, which means keeping them warm and avoiding too much pressure on them from over exercising. The toes are very vulnerable to gout attacks, and gout is a progressive disease by nature. This means wrapping your feet up warmly during the day, and at night keeping the feet warm. You might for example use an electric blanket or wear woolen socks at night. What applies to the toes, applies to the whole foot too.
As far as medications are concerned, uric acid lowering and pain killing meds will probably be prescribed.
Dietary counter measures can be found all across this website. Start at the home page (top navigation bar button: left) if you've arrived at this website on this page.
Are there specific medications for ankle gout ?
There are no specific medicines for ankle gout itself. Because the MSU gout crystals are basically the same wherever they are deposited in the body, (although they can vary in size), the control of gout, and halting attacks, depends on reducing uric acid (UA)to below 6.0 mg/dL.
This is a general, across-the-board number which in reality varies from person to person. It's usually the case that gout attacks won't end until you breach this number, or your personal variation of it. Many people will need it to be lower than 6.0 mg/dL for this happy event to occur. And you may have to be at or below the crystal dissolving UA level for some time before it happens.
DEALING WITH ANKLE GOUT PAIN
Ice or heat If your gout foot pain medications aren't working, here's something that can be done until you get one that does. Most people think that ice, or ice cold water, is better for gout foot pain (and gout pain generally) than heat, but a minority think the opposite.
If you prefer coldness, put your ankle up on a pillow (or elevate your foot some other way) and use a bandage to wrap a bag of frozen peas (you can always eat them later) around the affected ankle. The peas, being small, circular and frozen, will fit themselves around your ankle snugly, at least until they de-freeze. If this works, "wear" another bag of frozen peas.
Epsom salts You can easily get your feet into a bowl of warm water to which you've added Epsom salts. (The amount you require will be on the packaging). The magnesium sulphate of these salts will relax the feet and ankles and the body generally. They may help to unstiffen the ankle or other foot attack location, perhaps reduce soreness and give some relief from ankle gout pain.
Don't expect too much, but it's worth finding out what relief they give you and at what stage of a gout attack. For example, they might be more helpful towards the end, when the pain is receding. It is also an excellent way of getting magnesium into the body, which is good for gout. Epsom salts are not expensive.
Footwear What kind of shoes should you wear? And read why wearing high heeled shoes is not a good idea if you have gout. Check out this popular page.
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