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Vascular Surgery

KNot, swelling in my mother`s lower right leg

08/16/2005

Question:

Hello-- I would like to thank you for the time you volunteer to answer questions for concerned patients and family members! My 62 year-old mother broke her right leg just above the ankle more than thirty years ago, before I was born. Apparently the break was very bad, and it didn`t heal properly. For as long as I`ve known her, there has been a painful, angry-looking purple knot a few inches above her ankle. (I always thought the knot was part of the bone that broke, but recently she told me it`s her aortic vein.)Her whole leg and foot from the knot down are reddish/purplish, and periodically she has trouble with her leg swelling and hurting her. Her lower leg is always tender and sore, even if it just brushes against something. She usually wears a thick, tight stocking. On one of our summer vacations when I was about eight, I remember that her leg and foot broke out in white blisters and she could hardly walk. Sometimes ulcers appear on it. Lately she has been having trouble again with the leg swelling and hurting. Her family doctor in our small town told her to take aspirins and stay off her leg. What I`m wondering is whether she needs to see a vascular surgeon to find out exactly what is wrong with her leg and whether it can be repaired. I`ve been really worried about her leg for a long time and don`t know why I waited so long to try to find out about it! Thank you so much.

Answer:

Thank you for your question. What you are describing sounds like a cluster of veins, something that will likely not impact on your mother's longterm health. (An "aortic vein" does not exist.) Often times when someone sustains a bad fracture, there can be associated injuries to veins, resulting in some becoming enlarged, thus the " reddish/purple knot". Her doctor has correctly advocated the use of compression stockings ("thick tight stocking") to help push the blood back where it should go. It would be helpful for here to undergo a venous Duplex study to evaluate whether the venous valves are working in the deep and superficial vein systems. If those are not working well, then a referral to a vascular surgeon would be appropriate. If the valves are normal, the thick stockings and aspirin are really all she needs. Good luck!

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Response by:

Amy B Reed, MD Amy B Reed, MD
No longer associated