Need Medical Advice on DDs Swollen Foot

<p>I know we have several MDs and other medical related fields on CC. We have a wierd medical issue going on with our 17yo DD. I'd like some opinions. Should we be concerned? </p>

<p>Last weekend, DD came home from her waitress job at the local pizzeria. She does a lot of walking and standing with little sitting. She also wears lousy shoes-flats with little support. She complained that her right foot hurt, esp when she put weight on it. Her ankle was slightly swollen, slightly red and warm to the touch. She says she did not trip, fall or have any other accident involving her foot. We put her to bed with some iBuprofen. Next day the foot is no better and the swelling has increased. More iBuprofen and a foot wrap for support. The next day is even worse. We take her to our doctor who is equally perplexed and prescribes antibiotics. That was two days ago. Today the swelling has progressed to the top of her foot and toes. She says that when she puts weight on it, her foot feels squishy. We have another appt with the doctor at 3pm. </p>

<p>Thoughts or ideas? Any questions I should be asking the Dr. this afternoon? Any real serious issues or conditions we should be concerned about at this time? All a do about nothing? Thanks.</p>

<p>I don't have suggestions but I recently had a similar experience. I did not fall or twist anything. My ankle and eventually the top of my foot swelled up and did not go away. This was back in July. I got real concerned and we were on our way to a week's vacation. I ended up going to an ER as it was a weekend and that was the only option and we were leaving town. Nothing was broken. They couldn't find a cause. They said if it wasn't better, to see my doctor on our return. It wasn't better and so I did see my doctor. He thought it was tendinitus. He had me use a stronger form of Ibuprofen and suggested physical therapy. I did physical therapy for about two months and it was a bit better but not all the way better. The physical therapist suggested I see an orthopedist which took a while to get an appointment. It was getting better by then but I kept the appointment. That doctor also thought it was tendinitus that gets better on its own and that it wasn't unheard of that it had taken this long. So, it bothered me for about three months. It recently got better. Coincidentally, over Thanksgiving, I did twist my ankle a bit in the clogs I was wearing and so now my ankle hurts again but my ankle and foot are not swelled now. </p>

<p>I don't know the cause for your daughter and I read up on various causes at the time but I hope it is just what my doctor said which was tendinitus and while it was a pain (literally) and the swelling lasted a long long time, I was glad that was all it was. So, maybe that is the case for your daughter but hopefully you will get some answers. On the one hand the internet is great as you can look up symptoms and find causes. But on the other hand, when I have done that, it gets me more anxious to read all the things it COULD be, when in the end, it isn't anything that bad.</p>

<p>It is good that you have another doctor's appointment. Was an X-Ray taken? One possible cause is a metatarsal fracture (called a march fracture, because soldiers have gotten them).</p>

<p>Metatarsal</a> Stress Fracture - March Fracture</p>

<p>Good luck, and let us know how if you got a diagnosis after her appointment.</p>

<p>Ask for an Xray. Sometimes a nondisplaced stress fracture does not show up at first in an Xray, but I would ask to start there. A stress fracture could explain pain and some swelling. The squishy feeling is the fluid in her foot. It is hard to explain why there would be in infection/cellultis with no wound/bite etc, but its possible.
My D has sprained her foot and separately her ankle and I have always been impressed with the large amount of swelling she got with just a strain/sprain of ligaments. </p>

<p>At her age gout, autoimmmune problems, other joint infections would be rare.</p>

<p>oops double posting</p>

<p>Has she had an x-ray done? Although symptoms do not present as a typical fracture, you never know what kind of autoimmune response she might be having? Swelling, redness and increases temp. generally indicate some kind of an infection.
I would most definately see a doctor that specializes in foot and ankle though, not your regular GP. Hard to say more without seeing it.</p>

<p>Cross posted here too</p>

<p>Lukestar, she could either be xrayed by an orthopedic surgeon, sports medicine doctor or your GP. In the past, I have had a GP miss a fracture on my child, that an orthopoedic surgeon later picked up. She may be sent to a physical therapist first, but I would insist some type of imaging be done first. By the time the original fracture was discovered and only treated by PT, a second one had also occurred.</p>

<p>No PT without and Xray. And early Xrays can miss something that a later Xray picks up. As the callous forms around the fracture, and new calcium lays down, it shows up on the X-ray. This process takes time to develop. But either way, she needs an X-ray, and if no fracture but not improrving with conservative management, either a second one or something else (bone scane, MRI) after another week. But we are getting ahead of ourselves.</p>

<p>Same thing happened to D, and although I couldn't see anything, and believe me, I poured over her foot methodically, the Dr. finally found where a bee stinger went in - nothing really sticking out, and hard to see the puncture site. He finally got it out, and her foot went back to normal. She didn't feel the sting.</p>

<p>Lukestar, another thing to keep in mind for possible other injuries is the alternate use of hot and cold compresses. Cold decreases the pain and swelling, heat is to bring white blood cells to the area to fight infection. I think that is the rational. I always liked
it better than giving a drug, and kids adore the attention. One is supposed to be used first (heat or cold), so check with your doctor.</p>

<p>Lukestar, make sure that the antibiotics given to your D cover MRSA- methicillin resistant staph aureus. Young healthy adults, including school kids and athletes have been found to get infected by this bug.</p>

<p>janey, heat wil cause more swelling.</p>

<p>Above they are talking about a stress fracture.. most likely a stress fracture is not going to show up because it's microscopic. You won't be able to find it until after it has started the healing process when you'll see an excess of bone growth on an X-ray.</p>

<p>Ranima, I'm not following the need for antibiotics to fight MRSA at this point. That's why MRSA came about in the first place. Anything happens and the first thing done is antibiotics.</p>

<p>It could simply be a matter of she's on her feet and therefore blood is pooling because for whatever reason the muscles are not pumping the blood back up through the veins in that leg.</p>

<p>Maybe try some RICE
Elevation (as high above the heart as possible)</p>

<p>Disclaimer - I'm not one of the medical folks on the board. That being said, the first thing I thought of was a possible spider bite? I've heard of reactions like your d's to spiders.</p>

<p>Everyone has advice and stories. Bottom line, with swelling, redness, warm to the touch, there is some active inflammatory process going on that needs a specialist, not a GP. The heat, redness and fluid does not sound like a stress fracture/bone problem. The fact that antibiotics did not help could be that the cause was not treated by the specific antibiotic or the source is some other inflammatory process. Go see a Rheumatologist. They are experts in inflammatory disease/problems.</p>

<p>You are all great. Thank you! I took notes on all above and now feel informed going into the doctor's office.</p>

<p>Good luck, keep us posted on the outcome, please.</p>

<p>Best type of doctor to visit for ankle/foot issues is a podiatrist. My D had a problem with ankle sprains and swelling for 18 months - saw her GP, did physical therapy, etc. X-rays were done - nothing unusual was seen. Bought good supportive shoes, wrapped her ankle for sports, etc. Swelling and sprains continued.</p>

<p>Finally made an appointment with a podiatrist - he observed D walk and took a look at the X-Rays from the GP. Within the first five minutes of the appointment he said take a look at this X-ray - see that bone there - your D has an extra bone in her foot.</p>

<p>Neither the radiologist nor the GP ever noticed the extra bone when they examined the X-rays.</p>

<p>Follow up from today's appt. Dr is still perplexed. The redness has gone way down and the ankle doesn't fee warm to the touch anymore. However, the swelling is definitely more pronounced. He said to finish out the antibiotics and added OTC Aleve as an anti-inflamatory. We also had an X-Ray taken that he and a radiologist will look at. Follow up appt Friday morning. In addition, he gave her an inflatable removable cast for added support. He fully admitted that this was a mystery. The next step if things don't improve is blood work and off to a specialist. Thanks for all the help and advice. He was impressed when I pulled out my sheet of questions and concerns that I got from everyone here on CC.</p>

<p>Sorry that you don't have an answer yet as to what is causing her problem. Was the xray negative on the initial reading? It does sound like a specialist would be prudent.</p>

<p>He told us that if he didn't call us tonight about the X-Ray, then that meant he didn't see anything obvious. The radiologist won't read it until tomorrow.</p>

<p>Could be some sort of autoimmune reaction.
I frequently see people that get better without a clear diagnosis. Keep in mind that swelling in itself is not dangerous. Keep her leg elevated as often as possible, especially at night!
Keep us posted!</p>