<s>[INST] My 4 year old complained of pain in his right ankle 2 days ago and we looked at it and it was swollen with a purplish bruise. Then tonight he complained of his other ankle hurting and it was swollen with reddish spots all over the swollen area which was about the size of my fist. Then I noticed a swollen area on his right shin also about the size of my fist. The area on his ankle is warm and both spots feel like there is fluid. [/INST] Hi, Ankle with bluish discoloration means bleeding into the joints. Do you have family history of any bleeding disorders. If so child needs evaluation for hemphilia A and B along with Von Willebrand disease. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Prasanna Lakshmi, Pediatrician </s>