Foot and ankle pain is common among children. A toddler can hurt her ankle if she falls accidentally while playing. A joint disease like arthritis could also be causing pain and inflammation. Contact your child’s pediatrician if pain or swelling seem severe, or if the pain persists.

Symptoms

A toddler may limp or have difficulty bearing weight when he experiences foot or ankle pain. Swelling, bruising and bone tenderness can be other symptoms when an injury occurs. You may be unaware of any trauma leading to the pain. In some cases, pain is related to birth defects, bone age or growth problems.

Clinical History

When diagnosing the cause of ankle pain, your child’s physician will take a thorough clinical history. He will want to know the location of the pain, when the pain began, if the nature of the pain changes with activity or rest, and whether the ankle was injured previously. The doctor may ask if there is a family history of disease that affects the bones and joints. It may also be necessary to rule out disorders that affect the muscles or involve the nervous system.

Physical Examination

Your child’s physician will perform a physical examination when trying to diagnose the cause of your toddler’s ankle pain. She may try to reproduce the pain, test the ankle for strength and see if it has limited range of motion. Depending on your child’s symptoms, the doctor may order X-rays, a CT scan, a bone scan or an MRI to take a closer look at the bones and muscles.

Bone Fracture

Foot and ankle pain in active toddlers is often caused by minor trauma or repetitive stress. Children tend to have stronger ligaments than bones or cartilage. As a result, a growth plate fracture is a more common injury than a sprain. Toddlers can suffer a sprain or strain, although it’s uncommon.

Sprain

Sprains happen when the muscles or the tendons, which connect the muscle to the bone, are stretched too much or torn. This problem can happen suddenly or develop over time. Toddlers usually aren’t involved in the kinds of physical activities that can cause a strain, but your child might have strained the ligaments in his ankle if he fell while climbing on something. Bruising with some tenderness may mean your child has a minor sprain. Severe pain, swelling, bruising and difficulty moving the ankle or bearing weight on it may indicate a bad sprain that involves a torn ligament or a broken bone.

Arthritis

An autoimmune disease such as arthritis could be causing your toddler’s ankle pain. Juvenile idiopathic arthritis, or JIA, also known as juvenile rheumatoid arthritis, is one of the most common chronic diseases of childhood, according to eMedicine.com. JIA involves chronic joint inflammation that often affects larger, weight-bearing joints like ankles, knees and wrists. Toddlers may experience morning stiffness and walk with a limp. Prognosis depends on the severity of the disease. How long juvenile arthritis lasts is unpredictable, but in most cases, the disease eventually goes into spontaneous remission. Treatment focuses on controlling pain, preventing joint damage and preserving joint function.