Ankle swelling and inflammation after Pregnancy

Question

I have had swelling and inflammation in my left ankle for over a year, which started when I was five months pregnant with my daughter – she is now ten months old and there is no sign of it disappearing. My doctor ordered bloodtests, the results from December show an ANA of 1:640 with a smooth staining pattern, ESR rate of 24mm/h, Plasma C Reactive Protein 13.0mg/l, FBC Normal, White cell count normal, liver function normal, HLA B27 antigen normal. The most recent test in April shows anti-cardiolipin antibody rate normal, a slightly elevated Plasma C level of 15.0mg/l, FBC and white cell normal, ESR rate 39mm/h. Can you tell me what this means – I have no other symptoms whatsoever and am healthy apart from the swollen ankle?

Answer

We can’t provide diagnoses on-line.  Usually a careful history and physical examination are needed.  Also, a rheumatoid factor and anti-CCP tests would be of interest.  Sometimes different kinds of arthritis need time to fully develop in order to identify their cause.  An ANA titer of 1:640 is significant though and one should always consider lupus seriously in a young woman with arthritis and positive ANA.

Joan Bathon, M.D.

About Joan Bathon, M.D.

Dr. Bathon was a Co-Deputy Director of the Division of Rheumatology at Hopkins Bayview. She was also the founder and director of the Hopkins Arthritis Center.