What causes swollen ankles in children?

If your ankles are swollen, you must pay attention to the causes, because if it is caused by some physical illness, the harm will be greater. When your ankles are swollen and painful, you must first understand whether it is edema caused by malnutrition. If it is nephritis edema or hepatic edema, it will also manifest as swollen ankles. The cause must be identified and treated symptomatically.

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.

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.

7. Venous edema

It is mostly caused by deep vein thrombosis or venous valve insufficiency, which leads to increased deep vein pressure and poor reflux, and small molecules in the blood penetrate into the tissue spaces around the blood vessels, forming low-protein edema.