Hello doctor, I am a 39-year-old male with a history of hypertension. My BP medication was changed for the past six months and doctor put me on Metosartan 50, and Amlodipine 5 mg. For four to five weeks, my ankle joints are swollen. I went to an orthopedic, and he asked for a venous Doppler lower limb. Other results CRP, vitamin B12, ANA, uric acid, are normal. ESR is 20. There are remarks in venous Doppler, and he suggested for a physician opinion. I am attaching the Doppler report. Please give your opinion.
Hello. I have gone through your Doppler report (attachment removed to protect patient identity). Before making the diagnosis, I want a few things pertaining to your problem, like your complaining of swelling of both ankles joints like on and off. 1. Do you have a fever with regards to swelling? 2. Do you have any history of injury? 3. Whether the swelling is continuous or is there any joint pains? 4. It is better if you can attach your picture of ankle joint. And do you a history of varicose veins? From the above Doppler, I can make an inconclusive diagnosis. Bilateral inguinal lymph node signifies infection that can be treated with proper antibiotics. And another one with prominent perforators of GSV (great saphenous vein) as it means initial stages of developing varicose veins might eventually lead to swelling of the leg.