From the Guidelines
Ankle effusion should be initially evaluated using radiography, as it can reveal osteoarthritis, calcified or ossified intra-articular bodies, osteochondral abnormalities, stress fractures, or evidence of prior trauma, with an accuracy of 53% to 74% in identifying ankle effusions 1. Ankle effusion, commonly known as water on the ankle, is an abnormal accumulation of fluid in the ankle joint. Treatment typically involves rest, ice, compression, and elevation (RICE protocol) for 2-3 days. Over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours) or naproxen (220-440mg twice daily) can help reduce inflammation and pain. For moderate to severe cases, a healthcare provider may perform joint aspiration to remove excess fluid and possibly inject corticosteroids like methylprednisolone (20-40mg) for immediate relief.
Key Considerations
- The presence of ankle effusion may indicate ligamentous injury or fracture, and radiography can help identify these conditions 1.
- If the effusion is accompanied by severe pain, inability to bear weight, fever, or persists beyond 2-3 weeks despite home treatment, medical attention should be sought promptly.
- It's essential to identify and address the underlying cause of ankle effusion, which may include injury, arthritis, gout, or infection.
Diagnostic Approach
- Radiography should be considered the initial imaging study, as it can reveal various conditions that may be causing the ankle effusion 1.
- Ultrasound may also be used to evaluate ankle effusion, especially in cases where radiography is inconclusive or additional information is needed 1.
Treatment Options
- Rest, ice, compression, and elevation (RICE protocol) for 2-3 days is the recommended initial treatment for ankle effusion.
- Over-the-counter pain relievers like ibuprofen or naproxen can help reduce inflammation and pain.
- Joint aspiration and corticosteroid injection may be considered for moderate to severe cases.
From the Research
Ankle Effusion Overview
- Ankle effusion is a condition characterized by the accumulation of fluid in the ankle joint, often caused by injury or trauma 2.
- The size of the effusion can vary, with an average size of 15 mm reported in one study 2.
Causes and Symptoms
- Ankle effusion can occur after an acute ankle injury, with most injuries resulting from a fall (73%) and inversion injuries (73%) 2.
- Symptoms of ankle effusion may include swelling, pain, and difficulty walking 3.
Diagnosis and Treatment
- The diagnosis of ankle effusion is typically based on clinical evaluation, and further investigations may not be necessary unless there are clinical indications 2.
- Treatment options for ankle effusion may include rest, ice, compression, and elevation (RICE), as well as medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) 4.