What is an Ankle Effusion?

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  • Written By: Mary McMahon
  • Edited By: O. Wallace
  • Last Modified Date: 31 October 2018
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Ankle effusion is a buildup of fluid in the ankle joint. Effusion causes pain and swelling in the ankle, and it can lead to complications because it may put pressure on tissues in the surrounding area and damage them. Treatment of ankle effusion depends on the severity of the effusion and the cause. Patients often see an orthopedic doctor or a foot and ankle specialist for treatment of ankle injuries, as these physicians have special training and experience and are skilled at managing such injuries. However, a general practitioner can also provide adequate care for basic injuries.

Effusion can occur inside the ankle joint as a result of trauma, inflammation, or infection. Sports are a common cause of trauma to the ankle which results in effusion, although swelling inside the joint can also occur as the result of a fall which twisted the ankle or a sharp blow to the ankle. Inflammation and infection may be caused by any number of factors ranging from autoimmune inflammation caused by an overactive immune system to infection as a result of contact with an infectious organism.


When viewed in medical imaging studies, the condition is characterized by a distinctive “teardrop sign,” a reference to the shape the fluid in the ankle takes. A doctor will order such studies to determine the extent of the swelling and to check for injuries which may not be apparent on physical examination. For example, there could be a hairline fracture of one of the bones in the ankle which leads to inflammation and swelling.

The first step in treating ankle effusion is trying to bring the swelling down so that the patient will be more comfortable. Anti-inflammatory drugs can be prescribed, including injections of steroids into the ankle to bring down heavy swelling. Patients may also be advised to ice and elevate the ankle to promote a reduction in swelling. If the joint is extremely swollen, it may be aspirated with a needle to remove the excess fluid.

When the joint swelling has been addressed, the doctor may address the cause. Fluid can build up inside the synovial space inside the ankle again, potentially causing a repeat of the ankle effusion and leading to complications. There may be steps which can be taken to reduce swelling in the future, such as bracing the ankle at work, gentle stretching to strengthen the joint, or taking a break from sports to allow the body to fully recover.


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Post 5

Can the swelling be from a cast that was put on too tight? The cast was initially for an ankle pain attributed to Posterior tibia tendinitis. I had it on for about five days until someone told me my toes are not supposed to be that fat.

Post 4

So what is done for this? I just recently had an ankle injury and am being referred to an orthopedic doctor because they believe it to be effusion. I am curious about what the treatments usually are? My injury was five days ago and if anything the swelling and pain has gotten worse! What do I do? Should I walk on it? I have been on crutches because of the uncertainty of a fracture. I am nervous and scared as this greatly impacts my job!

Post 3

I have an ankle joint effusion due to a "cat leap" movement. My ankle twisted inwards. I can walk normally but when my ankle is twisted inward, I feel extreme pain. Also after jogging, I feel a mild pain in my ankle. Please let me know how I can treat it completely. Thank you.

Post 2

My sister runs track and was complaining about her ankle paining so my parents took her to the hospital. They took a film of her ankle but couldn't find anything wrong.

We went home, but it didn't get better. She went to the hospital again and they took another film, but used something called sonography this time. They found the ankle effusion that time around.

The doctor said that they couldn't see the effusion from the first film because it was too small. Sometimes they need to use a more sensitive film to find it. So just because it wasn't seen in a regular film doesn't always mean that it's not there.

Post 1

I had an ankle effusion two years ago but mine was because of rheumatoid arthritis.

The doctor confirmed the effusion after looking at my radiograph. He wasn't sure of the cause at first, it took several different tests to figure our what the problem was.

I didn't have an ankle fracture so that was ruled out from the beginning. Then I had blood tests done to check for infections and that was ruled out also. They also checked to make sure that it wasn't from an allergic reaction. The only other thing left was my arthritis and that was finally confirmed.

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