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Suggest Treatment For Swollen Instep

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Posted on Sat, 4 Jul 2015
Question: Dr. Rynne

I live in XXXXXXX but am currently in Florida away from my primary care physician
i am irish born and studied at UCG 1962 to 1966.

I have swollen instep(top part between ankle and toes) right foot. My left foot is slightly swollen
It is not very sore . This came on about 1 week ago. I tried ice but it did not seem to affect it.

I am 71 years and weigh 280 lbs (20 Stone)

i have been on the following drugs for 3 to 4 years now

1. Warfarin/Coumadin 5 MG per day

2. Lisinopril (for high Blood Pressure) 10 MG per Day

3. Pravastatin (high Cholesterol) 40 MG per day

4. Metroprolol (200 MG. Perv day) Heart problems

5. Trospium (Chloride) Urine Leakage 20 Mg. Per day.

the heart conditions i have been treated for are atrial fibrillation, cadiomyopathy,
atrial tachycardia and ventricular tachycardia.

i do not have diabeteis as far as i am aware and feel quite well.
doctor
Answered by Dr. Panagiotis Zografakis (3 hours later)
Brief Answer:
it needs medical assessment

Detailed Answer:
Hello,

a swelling on the foot needs clinical examination to reveal clues to its cause. Potential causes may include:
- bruising because of warfarin. Even minor injuries may cause it. The patient may not remember the injury sometimes. Discoloration is expected because of hematoma formation.
- muscle or tendon injury. Patients usually remember sprains or strains but they may have no memory of it.
- infection. Usually accompanied by fever, redness, warmth and pain.
- vein insufficiency or thrombosis. Clues to vein problems may include engorged veins of the legs.
- heart failure. Pitting edema is common.

Feeling pain usually excludes heart failure and chronic vein insufficiency but I can't exclude any of the rest. Clinical examination is needed and perhaps radiological tests.

Ice can be very helpful for injuries (sprains, strains) for the first 3 days but it won't affect the outcome after that. Try foot elevation and avoid using it too much (avoid moves that cause pain or discomfort). If the affected area is warmer than the surrounding skin and particularly if you've got fever, immediate medical assessment would be required.

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3810 Questions

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Suggest Treatment For Swollen Instep

Brief Answer: it needs medical assessment Detailed Answer: Hello, a swelling on the foot needs clinical examination to reveal clues to its cause. Potential causes may include: - bruising because of warfarin. Even minor injuries may cause it. The patient may not remember the injury sometimes. Discoloration is expected because of hematoma formation. - muscle or tendon injury. Patients usually remember sprains or strains but they may have no memory of it. - infection. Usually accompanied by fever, redness, warmth and pain. - vein insufficiency or thrombosis. Clues to vein problems may include engorged veins of the legs. - heart failure. Pitting edema is common. Feeling pain usually excludes heart failure and chronic vein insufficiency but I can't exclude any of the rest. Clinical examination is needed and perhaps radiological tests. Ice can be very helpful for injuries (sprains, strains) for the first 3 days but it won't affect the outcome after that. Try foot elevation and avoid using it too much (avoid moves that cause pain or discomfort). If the affected area is warmer than the surrounding skin and particularly if you've got fever, immediate medical assessment would be required. I hope you find my comments helpful! You can contact me again, if you'd like any clarification or further information. Kind Regards!