First of all, ankle pain is common as the ankle is a weight bearing joint between the foot and the lower end of the tibia and fibula bones. There are joint surfaces of the tibio-calcaneal joint (the “proper ankle joint”), but underneath there is also the subtalar joint, which often irradiates pain into the ankle joint area. Ankle pain is simply a symptom due to an underlying disease. This can be caused by arthritis, by trauma (like in a strain or fracture), can result from a nerve injury and entrapment (like the sensory branch of the superficial peroneal nerve), osteoporosis or circulatory problems. Follow the links to tell you more about common conditions that produce ankle pain with a few comments, too regarding causes.
It is the physicians task to order tests like X-rays and blood tests. X-rays will rule out fractures, arthritic changes, osteoporosis and other conditions. Blood tests can show inflammatory conditions and can discern between Lupus (high ANA titers), rheumatoid arthritis (high RA titers) and gout (high uric acid level). A thorough examination will tell the physician where the symptoms come from, whether it is from the joint surface, the tendons or the ligaments.
Sometimes not all of the questions regarding causation can be answered using all of these tests. However, a treatment trial will often get the final answer. A reassessment after the initial tests and treatments will often shed new light on the situation. Sometimes at that time the final diagnosis becomes obvious, which was hidden before.
1.The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 49.
2. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
3. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
4. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
5. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008