[jyl]

Doubt pics would show anything - the ankle looks normal, maybe just slightly swollen.

Yes, have been switching between the 911 and the Vanagon, and double-clutching - but only drive 8 miles/day, like 15 minutes a day.

I know this is too vague to diagnose from my inexpert description. I'm more wondering if any of the possible causes that come to mind are conditions that require me to go to a doctor in order to avoid some permanent damage.

In other words, suppose it were gout - if you don't seek care during a short episode (a week long or less) but simply let the episode pass, does that typically make the underlying condition any worse?