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Ankle Swelling in the Summer?

Seasonality of Ankle Swelling
Population Symptom Reporting Using Google Trends

You might expect to see an increase in sprains, strains, and fractures in the winter when patients are navigating icy sidewalks and shoveling loads of snow. What problems cross our path more in summer?

In my practice, complaints of ankle swelling are more common in the summer and are usually brought to clinic by injury-free and otherwise healthy patients. We established this phenomenon in our 2016 publication, Seasonality of Ankle Swelling.

“Each summer we encounter an increased volume of patients complaining of ankle swelling—patients who do not go on to develop cardiovascular, venous, or lymphatic disease … we looked for seasonal modulation in the public’s interest in ankle swelling as measured by the volume of Google Internet searches related to ankle swelling.”

While clinicians can expect to see an increase of swelling related complaints in office, many such patients will not seek medical advice. Whereas Internet searches for ankle swelling (or related terms) are highest in the summer, hospital admission for heart failure exhibit the opposite trend and peak in the winter. So, rest assured, your patients are certainly not alone—and probably in good health.

About the author

Scott Garrison, MD PhD
Associate Professor, Department of Family Medicine, University of Alberta
Director, Pragmatic Trials Collaborative

Scott spent the first 20 years of his professional career as a full time fee-for-service family physician. He has a passion for evidence-based medicine and left full time clinical practice in 2013 intent on pursuing clinical trials that address important, as yet unaddressed, primary care questions. He is working to build a platform for large primary care trials in both BC and Alberta.

Prevention and Management of Cardiovascular Disease Risk in Primary Care

Toward Optimized Practice (TOP) introduces a new clinical practice guideline (CPG): Prevention and Management of Cardiovascular Disease Risk in Primary Care.

By removing lipid targets and associated monitoring of lipid levels, as well as other streamlining measures, the management of lipids and cardiovascular disease risk has been significantly simplified. Additionally, by targeting risk, clinicians can identify patients most likely to benefit while actively involving these patients in their care.

The collaboration between the ACFP’s Evidence and CPD program team  and TOP has created a guideline and recommendations based on the most recent and highest quality of evidence. The background evidence to create the guideline included a review of more than two hundred articles. Authors for the Evidence Review include: Drs. Adrienne Lindblad, Mike Kolber, Scott Garrison, Mike Allan, and Ms. Candra Cotton.

This Prevention and Management of Cardiovascular Disease Risk in Primary Care guideline balances evidence, simplification/efficiency, and patient involvement. Related files are available from the TOP website:

The Prevention and Management of Cardiovascular Disease Risk in Primary Care CPG recently received an endorsement from the College of Family Physicians of Canada.

Welcome to the Doc Blog

Physician-Led Practice Improvement

This blog is managed by the ACFP and aims to share with you relevant topics of discussion, information, and stories and experiences. Contributions are driven by your peers and physician-led. This recent post includes additions from the Communications Committee.

The main motivation is to aggregate interesting and relevant articles that will save you time and improve your practice. Here are some articles your peers found interesting: