Differential Diagnosis for Ankle Burning and Swelling

Single Most Likely Diagnosis

• Ankle Sprain: This is the most common injury causing ankle pain, burning, and swelling, often resulting from rolling, twisting, or landing awkwardly on the ankle. The burning sensation can be due to the inflammation and irritation of the ligaments and surrounding tissues.

Other Likely Diagnoses

• Cellulitis: A bacterial skin infection that can cause redness, swelling, warmth, and pain in the affected area, including a burning sensation. It's more likely if there's a break in the skin.
• Achilles Tendinitis: Inflammation of the Achilles tendon, which can cause pain, swelling, and a burning sensation in the back of the ankle.
• Gout or Pseudogout: These conditions involve the deposition of crystals within the joints, leading to sudden, severe pain, swelling, and redness. The burning sensation can be part of the inflammatory response.
• Ankle Fracture: A break in one or more of the bones in the ankle can cause pain, swelling, and sometimes a burning sensation due to the injury and subsequent inflammation.

Do Not Miss Diagnoses

• Deep Vein Thrombosis (DVT): Although less common, DVT can cause swelling and pain in the ankle and leg. It's crucial to consider this diagnosis, especially in patients with risk factors for DVT, as it can lead to life-threatening pulmonary embolism if not treated promptly.
• Osteomyelitis: A bone infection that can cause pain, swelling, and redness in the affected area. It might present with a burning sensation and is a critical diagnosis to consider due to its potential for serious complications.
• Septic Arthritis: A joint infection that can cause severe pain, swelling, and redness. It's a medical emergency requiring prompt diagnosis and treatment to prevent joint destruction.

Rare Diagnoses

• Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet. It can be primary or secondary to other conditions.
• Complex Regional Pain Syndrome (CRPS): A condition characterized by persistent burning pain and inflammation following an injury, which can affect one of the limbs after an injury or trauma.
• Neuroma: A growth or tumor of nerve tissue that can develop in various parts of the body, including the ankle, causing pain, burning, and swelling.

Each of these diagnoses has distinct features, but some can present with overlapping symptoms, making a thorough clinical evaluation and sometimes additional diagnostic tests necessary to determine the correct diagnosis.