Ankle Swelling for One Week Without Trauma
You need urgent medical evaluation to rule out serious non-traumatic causes including deep vein thrombosis, septic arthritis, and inflammatory arthropathy—do not apply standard ankle sprain protocols without a clear injury mechanism. 1
Critical First Step: Establish Whether Trauma Occurred
The absence of a traumatic mechanism (such as inversion injury during plantar flexion) fundamentally changes your diagnostic approach and excludes standard sprain management protocols. 1 Without trauma history, you cannot assume ligamentous injury and must consider systemic or inflammatory causes. 2
Immediate Medical Evaluation Required For:
- Deep vein thrombosis: Unilateral ankle swelling without trauma is a red flag for venous pathology and requires urgent assessment 1
- Septic arthritis: Can present with isolated joint swelling and tenderness even without fever or skin redness 1
- Inflammatory arthropathy: Gout, pseudogout, or rheumatoid arthritis commonly cause atraumatic joint swelling in adults 1
What You Should Do Now:
Seek medical attention immediately for proper diagnostic workup, as persistent swelling for one week without improvement warrants evaluation. 2 While awaiting evaluation:
- Avoid activities that cause pain 2
- Elevate the affected ankle to help reduce swelling 1
- Consider NSAIDs for pain and swelling control, though use cautiously as they may suppress natural healing processes 2
Red Flags Requiring Emergency Evaluation:
Activate emergency services if you develop: 2
- Inability to bear weight
- Rapid worsening of swelling
- Development of redness suggesting infection
- Coldness or numbness in the foot
- Systemic symptoms like fever
Common Pitfall to Avoid:
Do not self-treat with RICE protocol (rest, ice, compression, elevation) or assume this is a simple sprain without establishing a traumatic injury mechanism. 1 Applying standard sprain protocols may dangerously delay diagnosis of infection, inflammatory arthritis, or venous thrombosis. 1
Why Standard Sprain Treatment Doesn't Apply:
Ankle sprains require a specific mechanism of injury—typically inversion while the foot is plantar-flexed. 2 The Ottawa Ankle Rules, which guide imaging decisions for ankle injuries, specifically apply only to acute trauma situations where the patient has pain in the malleolar zone plus either bone tenderness or inability to bear weight immediately after injury. 2, 3 Without trauma, these rules and associated treatment protocols are inappropriate. 1