Mri results. Help please

I fell down some stairs and quite badly sprained my ankle 4.5 months ago. Initially I was sent from a&e with no treatment. 1 month later still in pain and trouble weight baring gp checked xray which said I had non displaced avulsion fracture of distal fibular tip. at 6 weeks I was given an aircast as getting no better. Still in aircast as it stops me going over on it. Had mri last week and results say no fracture or dislocation. Ligaments and tendons seem ok. Mild effusion is posterially on ankle with ganglion cyst around os trigonum. Some degenerative changes on sub talar. Any one got a clue what this means and why am I still in lots of pain and unstable. Thank you

10 Replies

  • Hi lynneyk is u ankle going hot & cold, I sprained my right ankle now I have CRPS in it, if u ankle is still no better then u should go back to u gp and get him to send u to a pain specialist he may sort it out for u

  • Hi thank you. Not so much hot and cold but swollen and red. I have still to attend fracture clinic in 2 weeks and physio this morning so will mention it then thankyou

  • It most likely comes to this - you have had some tissue changes (that cyst, or os trigonum syndrome) due to the impact you experienced. Bottom line, you need someone different to look at it - the people you've seen apparently don't get it. If it was me, I'd look around for a chiropractor - they often have a lot of training (depending on their form of practice) that would make them ideal to help with this. Ask friends for a recommendation, then call them and mention those two things to see if it's within their scope of practice.

  • Hi Lynneyk

    Horrible to be in so much pain and unstable on your feet. Please find attached the following which may shed some light on what you're experiencing. Unfortunately, it's not unusual after a fall like your's.

    Ankle effusion is a buildup of fluid in the ankle joint. Effusion causes pain and swelling in the ankle, and it can lead to complications because it may put pressure on tissues in the surrounding area and damage them. Treatment of ankle effusion depends on the severity of the effusion and the cause. Patients often see an orthopedic doctor or a foot and ankle specialist for treatment of ankle injuries, as these physicians have special training and experience and are skilled at managing such injuries. However, a general practitioner can also provide adequate care for basic injuries.

    Effusion can occur inside the ankle joint as a result of trauma, inflammation, or infection. Sports are a common cause of trauma to the ankle which results in effusion, although swelling inside the joint can also occur as the result of a fall which twisted the ankle or a sharp blow to the ankle. Inflammation and infection may be caused by any number of factors ranging from autoimmune inflammation caused by an overactive immune system to infection as a result of contact with an infectious organism.

    In regards to your avulsion fracture, just to let you know that it can take some time to set/heal often because of the swelling mentioned above. The fact that the bones haven't moved significantly out of place is why it's called 'non displaced' but that's also positive because it means it will re-set, how long it will take very much depends on how old you are and how well your immune system works.

    Try not to worry, don't forget your R.I.C.E. -

    Rest as much as possible - we often underestimate the power of rest.

    Ice - put a pack on to ease the pain - don't leave on for more than five minutes at a time.

    Compression - the air pack is great. If you can manage one of those stretchy support sleeves, get one on. You can't go wrong. You can even put the ice pack over it so you don't need to constantly remove it. Finally...

    Elevate, while resting, try to put pillows, cushions or whatever will help to raise your leg above the level of your heart. It's easier when you're lying down but do your best when you're sitting as well.

    Sorry this is so long. Hope it helps.

    All the very best wishes. Do let us know how you get on.

  • I would suggest that some physiotherapy might be useful. You could get a referral from the GP or see if you can get a recommendation for someone with a good reputation in the local area if you are in a position to pay privately.

    To be honest the most medical training I have is a Brownie badge in First Aid (when I was 7!) but I can say from personal experience that similar problems I have had have only been relieved by physio. Take the results of the MRI with you to the physio. He/she will understand exactly what it all means.

    Good luck.

  • Hi thanks for all your comments. I have been having physio for 8 weeks this morning she performed acupuncture And also changed my exercises. She thinks the os trig and cyst are impinging my ankle and because it has been so long I should be pushing for surgery to remove os. Also the pain won't be helped by arthritis of subtalar. I am under a rheumy for suspected psoriatic arthritis so dont know if it is that in ankle x

  • No I cannot help you but do send hugs. I did though have you a private physiotherapist in your area. Maybe a few pounds to them would assist you in finding out what is wrong in a different way to the doctors. Otherwise see your GP and ask for the report in English.

  • It means that the original injury damaged not only the bone but also the tendons/ligaments around the joint. The ankle is unstable because the soft tissue is still under stress and thus inflamed. The effusion is coming from that inflammation. I did a similar injury threeand a half years ago, teraing a ligament but not breaking the bone. The joint is still painful at times. You should have strengthening exercises from a sports physio if possible. Wear a support bandage too.

  • If you do not use muscles they shorten and tighten. The older one is the worst the problem is. You need to both exercise your leg muscles as well as stretch them. This is an area where you need the services of a hands on therapist who can feel what your muscles are doing and give appropriate advice.

    Not sure what you mean by unstable. Behaviour of muscles is dependant on spinal reflexes which are fed information from proprioceptors attached to muscles. Muscles need to be non-contracted for these to work efficiently and effectively. Hence the need for a hands on therapist.

    Hope this helps.

  • I recommend you to first try the physiotherapy. later if don't feel comfort and relaxation then consult with your orthopedic surgeon.

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