Urgent AssessmentNew sudden-onset leg swelling — especially one leg, warm and red — may be deep vein thrombosis (DVT). Bilateral swelling with breathlessness suggests heart failure. Both need urgent assessment.
Causes by Pattern
| Pattern | Likely Cause |
|---|---|
| One leg, warm, red | DVT — urgent assessment |
| One leg, varicose veins | Chronic venous insufficiency |
| Both legs, worse at end of day | Venous insufficiency, prolonged standing |
| Both legs + breathlessness + fatigue | Heart failure |
| Both legs + facial puffiness + frothy urine | Nephrotic syndrome (kidney disease) |
| Both legs + jaundice + spider naevi | Liver cirrhosis (low albumin) |
| Pitting oedema + hot joints | Reactive arthritis |
Elevate and MoveFor simple venous oedema, elevating legs above heart level for 30 minutes, 3–4 times a day, and walking regularly significantly reduces fluid accumulation.
Is ankle swelling at the end of the day normal?
Mild ankle swelling that resolves overnight after elevation is common, especially after long periods of standing or sitting. It's usually benign but worth mentioning to a GP if persistent.
Can heart failure cause swollen ankles?
Yes — bilateral ankle and leg oedema is a classic sign of right-sided heart failure. It's usually accompanied by breathlessness, fatigue, and raised jugular venous pressure.
What blood tests check for the cause of oedema?
Key tests: BNP or NT-proBNP (heart failure), eGFR + urine protein (kidney disease), albumin + LFTs (liver disease), TFTs (hypothyroidism causes non-pitting myxoedema).
How is DVT diagnosed?
Clinical assessment + D-dimer blood test. If D-dimer is raised or clinical suspicion is high, a Doppler ultrasound of the leg veins is performed — it's highly accurate.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.