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ankle instability-results of MRI

Posted by Kim R on 5/16/03 at 18:50 (119040)

I sprained my ankle at a ski lodge 7 weeks ago. I tripped in a pothole full of water and suffered a severe inversion injury that has a no improvement. I work in a job that demands my ability to walk and stand. I currently can not stand for 50 minutes-1 hour. Have been unable to work for 6 weeks. Pain is incredible though x-rays yield normal results. I was recently diagnosed with a grade 3 atfl sprain and underwent an MRI. Because I have not improved much and am demonstrating signs of instability I was told to plan on having surgery but was then told that my MRI was within normal limits. I usually walk at an extremely fast pace and have been unable to do so for the duration of my injury. The ankle has shooting stabbing pains, sometimes burning when I walk on it. I am limping and moving at an extremely slow pace. Walking on uneven ground is painful, walking fast, night pain is extreme, climbing stairs is getting harder and harder. I am not allowed to walk around except in an ankle brace. Chronic pain on the 3-4 scale in upwards of 10 after walking short distances.

Alignment is normal witrhn left ankle. There is no evidence of subacute fracture. There is subcortical bone marrow edema within the posterolateral aspect of the talar dome. There is no eividence of 'kissng' contusion within the adjacent tibial plafond. There is an equivocal area of bone marrow edema within the posterior talar dome lies immediately to the attachment of the posterior talofibular ligament.

No other bone marrow signal abnormality is identified. The anterior talofibular ligament is somewhat ill defined but felt to be intact. The calcaneal fibular ligament is not well seen. The medial ligamentous structures are intact. The syndesmotic ligaments are intact as well. No sognificant soft tissue swelling is seen about the ankle.

Mild effusion is present within the tibotalar joint space. Negative for focal chodrol abnormality. There is no evidence of tarsal coalition. Ther peroneal and posterior flexor tendons as well as the anterior extensor tendons demonstrate normal thickness in signal. The plantar aponeurosis is normal in its appearance.

1. Small area of subcortical bone brusing within posterior lateral talar dome. No definate overlying chondral abnormality is seen as this area of brusiing is subjacent to the posteriorlateral weightbearing surface of the talr dome.

2. Mild effusion within the tibotalar joint space. This may refelct capsular injury.

3.grade definition to atfl which is felt to be intact. No other ligamentous abnormality is seen within the left ankle

4.Negative for occult fracture within the left ankle.

Re: ankle instability-results of MRI

Dr. Z on 5/16/03 at 21:53 (119060)

There is no report on the ligaments. Are they torn? May have to be placed into a cast non-weight bearing. First need to see the the condition of the lateral collateral ligaments