Why is my left ankle swollen?

We often encounter such situations in life: some people are obviously very thin, but their ankles are very swollen, making them look very fat. In fact, this is mostly due to edema caused by diseases in the body. I believe that most people are unclear about the cause of swollen ankles. If you want to get effective treatment, you must first understand the cause. Let’s take a look at why the left ankle is swollen.

Specific causes of swollen ankles

1. Nephrogenic edema

It is mainly seen in various types of nephritis and kidney disease. The pathogenesis is mainly caused by multiple factors that cause reduced renal excretion of water and sodium, leading to sodium and water retention, increased extracellular fluid, increased capillary hydrostatic pressure, and causing edema. The characteristic of edema is that in the early stage of the disease, there is eyelid and facial edema when getting up in the morning, which later develops into systemic edema. Urine changes, high blood pressure, and renal impairment are common.

2. Hepatic edema

It is mainly found in patients with decompensated cirrhosis, and the pathogenesis is mainly portal hypertension, hypoproteinemia, hepatic lymphatic reflux disorder, and secondary aldosterone increase. There are 2 aspects to liver function and portal hypertension.

3. Malnutrition and edema

It is mainly due to hypoproteinemia or vitamin deficiency caused by long-term nutritional deficiency due to chronic wasting diseases, protein-losing gastrointestinal diseases, severe burns, etc. The characteristic is that edema is often preceded by emaciation and weight loss. Edema often starts in the feet.

4. Myxedema

It is mostly caused by excessive protein content in the tissue fluid, and is more common in hypothyroidism, with obvious symptoms on the face and lower limbs.

5. Drug-induced edema

It is often seen in treatments with glucocorticoids, androgens, estrogens, insulin, etc.

6. Lymphedema

It is divided into 2 categories: primary school and secondary school. The former is caused by abnormal development of normal lymphatic vessels and is rare in clinical practice. The latter is often caused by recurrent erysipelas, filariasis infection or regional lymph node dissection and is more common.

Although the causes of lymphedema are different, the pathological changes are roughly similar: in the early stage of the disease, lymphatic return is obstructed, resulting in increased pressure in the lymphatic vessels, twisting and dilation of the lymphatic vessels, and gradual loss of valve function, resulting in lymph reflux, which ultimately affects the capillary lymphatic vessels from absorbing interstitial fluid and large molecules, causing fluid and protein to accumulate in the tissue spaces and thickening of the subcutaneous tissue. At this time, the skin is still smooth and soft, and there are indentations when pressed with fingers.

If the lesion persists, under the long-term stimulation of high-protein edema fluid, the skin and subcutaneous tissue will produce a large amount of fibrous connective tissue, and the walls of the lymphatic vessels will gradually thicken, fibrose, and even harden, making it more difficult for tissue fluid to enter the lymphatic vessels, and interstitial edema will become more serious. At the same time, local sweat gland and sebaceous gland dysfunction can easily lead to infection, further promoting local tissue fibrosis and aggravating lymphatic vessel obstruction. This vicious cycle causes lymphatic lesions to continue to worsen. Over time, the skin becomes thicker, rougher, and harder like elephant skin, so it is also called elephantiasis.

7. Venous edema