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Recent MRI

Posted by Diana B on 2/16/01 at 07:13 (039122)

Hi, I've posted before and I'm still reading eveyone's posts,this site has helped me understand my foot problems a great deal. I am 5 months post op after a full release. I just had an mri to find out about my ankle pain.{my heel feels great}. Well according to the mri, I have arthritis, tenosynovitis, and a bony defect in my ankle. The arthritis I understand. My doctor didn't seem too concerned about the tenosynovitis,but did wonder about the bony defect. Maybe someone can enlighten me on these conditions.
He wants to send me for a ct scan, for the bony defect,and gave me a cortisone shot in my ankle{outer}.I see him again on Tuesday, and if anyone has any idea of what to ask about let me know. I was hoping it would have been a good visit and didn't think to ask questions, so please help me prepare for my next visit.If it helps any I sprained my ankle 2 halloweens ago. Thanks for any help you can give me. Diana

Re: Recent MRI

Dr. Kosova on 2/16/01 at 22:51 (039227)

Diana B,

What is the tenosynovitis of and does it hurt you? Get the ct scan and listen to your Dr. This is a good course of action. Sometimes boney defects are nothing and sometimes they are problems. Did he mention a transchondral defect of the ankle joint. Have you had ongoing pain in this ankle since the halloween sprain? How old are you? Questions will really depend on what they will find then what will be their course of tx. Keep us posted.

Dr. Kosova

Re: Recent MRI

Diana B on 2/16/01 at 23:15 (039228)

Let me start by saying that I am 36 y/o and have had foot problems since before the sprain, that was just icing on the cake.The tenosynovitis, I believe is on the inside of my ankle. My doc didn't get into that too much.
I do believe that a transchondral defect of the ankle joint was mentioned in the report. I had a copy of it but I gave both to my doc.It's hard to tell if I've had ankle pain since the sprain because so much has been going on in my foot. My first mri showed this boney defect, but not as clear as this one. My main question is should I just accept the fact that my foot is always going to be a problem, or is there hope for fixing any of these problems. My attitude is to expect the worst and hope for the best. But what is the worst that can be wrong?I hope I am making sense to you, because it really is confusing me. Thanks for listening Diana

Re: Recent MRI

Dr. Kosova on 2/16/01 at 23:33 (039230)

Diana
The tenosynovitis is probably from the posterior tibial tendon and this can become a big deal if not treated properly. NO.NO. NO. Do not except the fact that you will live with pain!! Some of these defects can be treated with ankle arthrosopy with great success. Some through casting and rest. Both of these problems are easily treated but first you have to see how bad the defect is . Ice the tendon to reduce the synovitis. And rest the foot and ankle as mauch as you can. Dont despair.

Dr. Kosova

Re: Recent MRI

Dr. Zuckerman on 2/17/01 at 06:56 (039241)

Here is your online second opinion . Listen to Dr. K . Lack of treatment and more important lack of a specific reason for the pain is worse.. We treat my ankle problems with ankle arthroscopy, cast or rest. So yes there is hope and happiness with a proper evaluation and treatment. So don't get discouraged and ask alot of questions.

Re: Recent MRI

Diana B on 2/17/01 at 16:38 (039269)

Does all this mean a third surgeryis possibly in my future? Rest sure does sound good but, I am getting ready to start school in 2 weeks and I must keep working too. If my foot is casted again would that be sufficient rest?
You'd think after all this time I'd know as much as a doctor about feet but stll is confusing. Is ESWT an option at this point and if it is is it covered by insurance yet? I live in the Philly area, not far from the Com. Barry Bridge.Thanks again

Re: Recent MRI

Dr. Zuckerman on 2/17/01 at 19:24 (039277)

Be happy to give you an onsite opinion if you want one. I am across the Phila bridge in South Jersey. Call my office at 1-856-848-3338

Re: Recent MRI

Dr. Kosova on 2/18/01 at 11:36 (039306)

Diana B,

Go to the Healtronics site to see if someone is in your area. esw tx with the Ossatron is covered by most insurances but it does take a couple of weeks for preceritification. What other sx have you had? Esw is for plantar facsia only and you need to deal with the other problems first. You want to be able to walk after esw. I have a patient that Has post. tibial tear and pf pain and I am reconstructing the post.tibial first. He was missdiagnosed by two other Drs. and hopefully after his sx and casting and physical therapy maybe his pf will be relieved. So again I would handle the more seroius problems first.

Dr. Kosova

Re: Recent MRI

Dr. Kosova on 2/16/01 at 22:51 (039227)

Diana B,

What is the tenosynovitis of and does it hurt you? Get the ct scan and listen to your Dr. This is a good course of action. Sometimes boney defects are nothing and sometimes they are problems. Did he mention a transchondral defect of the ankle joint. Have you had ongoing pain in this ankle since the halloween sprain? How old are you? Questions will really depend on what they will find then what will be their course of tx. Keep us posted.

Dr. Kosova

Re: Recent MRI

Diana B on 2/16/01 at 23:15 (039228)

Let me start by saying that I am 36 y/o and have had foot problems since before the sprain, that was just icing on the cake.The tenosynovitis, I believe is on the inside of my ankle. My doc didn't get into that too much.
I do believe that a transchondral defect of the ankle joint was mentioned in the report. I had a copy of it but I gave both to my doc.It's hard to tell if I've had ankle pain since the sprain because so much has been going on in my foot. My first mri showed this boney defect, but not as clear as this one. My main question is should I just accept the fact that my foot is always going to be a problem, or is there hope for fixing any of these problems. My attitude is to expect the worst and hope for the best. But what is the worst that can be wrong?I hope I am making sense to you, because it really is confusing me. Thanks for listening Diana

Re: Recent MRI

Dr. Kosova on 2/16/01 at 23:33 (039230)

Diana
The tenosynovitis is probably from the posterior tibial tendon and this can become a big deal if not treated properly. NO.NO. NO. Do not except the fact that you will live with pain!! Some of these defects can be treated with ankle arthrosopy with great success. Some through casting and rest. Both of these problems are easily treated but first you have to see how bad the defect is . Ice the tendon to reduce the synovitis. And rest the foot and ankle as mauch as you can. Dont despair.

Dr. Kosova

Re: Recent MRI

Dr. Zuckerman on 2/17/01 at 06:56 (039241)

Here is your online second opinion . Listen to Dr. K . Lack of treatment and more important lack of a specific reason for the pain is worse.. We treat my ankle problems with ankle arthroscopy, cast or rest. So yes there is hope and happiness with a proper evaluation and treatment. So don't get discouraged and ask alot of questions.

Re: Recent MRI

Diana B on 2/17/01 at 16:38 (039269)

Does all this mean a third surgeryis possibly in my future? Rest sure does sound good but, I am getting ready to start school in 2 weeks and I must keep working too. If my foot is casted again would that be sufficient rest?
You'd think after all this time I'd know as much as a doctor about feet but stll is confusing. Is ESWT an option at this point and if it is is it covered by insurance yet? I live in the Philly area, not far from the Com. Barry Bridge.Thanks again

Re: Recent MRI

Dr. Zuckerman on 2/17/01 at 19:24 (039277)

Be happy to give you an onsite opinion if you want one. I am across the Phila bridge in South Jersey. Call my office at 1-856-848-3338

Re: Recent MRI

Dr. Kosova on 2/18/01 at 11:36 (039306)

Diana B,

Go to the Healtronics site to see if someone is in your area. esw tx with the Ossatron is covered by most insurances but it does take a couple of weeks for preceritification. What other sx have you had? Esw is for plantar facsia only and you need to deal with the other problems first. You want to be able to walk after esw. I have a patient that Has post. tibial tear and pf pain and I am reconstructing the post.tibial first. He was missdiagnosed by two other Drs. and hopefully after his sx and casting and physical therapy maybe his pf will be relieved. So again I would handle the more seroius problems first.

Dr. Kosova