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Leflunomide, sold under the brand name Arava among others, is an immunosuppressive disease-modifying antirheumatic drug , [8] used in active moderate-to-severe rheumatoid arthritis and psoriatic arthritis. It is a pyrimidine synthesis inhibitor that works by inhibiting dihydroorotate dehydrogenase. [9] Bottle of Leflunomide (Arava) and tablet
Patients present with an acute onset of swelling, pain, erythema, prominent tenderness, warmness and limited range of motion in both ankles. [1] [2] Lower legs and heels may also be involved, however the distal parts of feet and toes are usually spared. Patients may also experience high-graded fever, pitting edema and hypotension.
The condition is commonly associated with vascular and cardiac changes associated with aging but can be caused by many other conditions, including congestive heart failure, kidney failure, liver cirrhosis, portal hypertension, trauma, alcoholism, altitude sickness, pregnancy, hypertension, sickle cell anemia, a compromised lymphatic system or merely long periods of time sitting or standing ...
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Causes of edema that are generalized to the whole body can cause edema in multiple organs and peripherally. For example, severe heart failure can cause pulmonary edema, pleural effusions, ascites and peripheral edema. Such severe systemic edema is called anasarca. In rare cases, a parvovirus B19 infection may cause generalized edemas. [9]
When symptoms grow worse (more on this later), heart failure can cause swelling in the ankles and legs, as well as swollen feet. This is due to edema, which is a fluid accumulation in the body ...
In cases of swelling, the extremities' circumference is measured over time for reference. In early stages of lymphedema, elevating the limb may reduce or eliminate the swelling. Palpation of the wrist or ankle can determine the degree of swelling; assessment includes a check of the pulses.
This inflammation can cause pain and stiffness [5] and is one of the most common causes of ankle problems. [ 7 ] In many types of arthritis, progressive joint degeneration in the joint occurs and smooth "buffered" cartilage is gradually lost, causing the bones rub against each other and wear, as well as the soft joint tissue.