A 65-year-old woman with a history of obesity presents with insidious onset of ankle pain and swelling. The pain worsens with activity and improves with rest. On physical examination, there is mild swelling and tenderness over the ankle. What should be considered, and what are the next steps?
Given her age and obesity, one possible diagnosis is ankle osteoarthritis, which results from wear and tear of the ankle joint over time. Pain that worsens with activity and improves with rest is a classic symptom of osteoarthritis. The next step is to obtain an X-ray of the ankle, which may show joint space narrowing, osteophytes, or subchondral sclerosis. Management usually involves lifestyle modifications, pain management with NSAIDs, and physical therapy.