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Thread: Swelling in lower leg

  1. #1

    Swelling in lower leg

    TIA for any feedback you can give. Last Sunday 8/20 I did my normal 1 hour FES ride. In the last few minutes I noticed my foot was sticking out of the boot just a bit more than normal but I only had about 9 minutes left and wasn't experiencing any AD so I finished the ride. Monday morning my right lower leg (knee, calf & ankle) were all swollen roughly 1" - 1 1/2" more than my left leg. I always have some slight swelling even though I wear compression hose daily. No redness, no bruising, no temp. difference, no AD even when doing my ROM's. Thoughts of a blood clot, I know. I've been on Warfarin since 2009 after a DVT in right leg and have been in my therapeutic range for a long time but I know blood thinners are not 100%.

    Fast forward to Thursday and a visit to my regular Internal Med Doc. He's thinking a possible fracture. Full blood work-up is normal, Xrays of knee, calf and ankle come back with "Subacute fracture of the proximal fibular metadiaphysis." I'm referred to ortho, which I see later that afternoon and he says, "I wouldn't even consider this a fracture and I don't know why you're here seeing me". He thinks it's a blood clot because a fibula fracture wouldn't cause ankle to knee swelling. Not real fond of the radiology report reading "fracture" and ortho saying not, WTH???

    Per my regular doctor (internal med) I will now get a venous ultrasound but that won't be until Friday 9/1 unless there's a cancellation.

    Swelling still is the same, slight increase in BP off and on during the day but nothing too bad. Of course, if I have any difficulty breathing, increased swelling and/or AD off to the ER I go.

  2. #2
    A Doppler for venous clots should be ordered as a "stat" emergency test if there is any question of a DVT. Call your physician back and get them to order it stat. A big pulmonary embolis can kill you instantly...waiting until you are short of breath or have chest pain could be disasterous.

    A minor ankle fracture in someone with an SCI can cause foot to knee edema, and also can lead to a DVT.

    Left leg edema can also sometimes be caused by constipation. Is your bowel program going OK?

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    Thanks KLD, for your response! I do plan to call first thing in the morning!

    Swelling still measures the same. No chest pain or shortness of breath. Do "feel" like I have some lower abdominal pain on right side. Appendix already gone. Curious, can quads get hernias?

    Xrays of the ankle were negative.

    Bowel program is going a bit long here the past little bit but I got a little slack with my fiber intake. No excessive swelling in left leg.

  4. #4
    Had ultrasound today. Thankfully, no clot! Told to follow-up in one week. No weight bearing or FES biking.

  5. #5
    Glad you got it moved up. It is an important "rule out" in such a situation.

    Just a review of above. A "subacute" fracture is one that occurred some time ago, and likely is partially or nearly completely healed. Can you remember a time in the last few months where you might have injured your ankle?

    If you were AB, a proximal fibular fracture would most likely be casted or splinted with no weight bearing or knee movement allowed for at least a month. Since that is just below your knee, it certainly could contribute to swelling of your lower leg for weeks or even months after the fracture, until all the swelling internally goes down and stops compressing lymphatic and venous drainage.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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