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my mri report for tts

Posted by marie c on 6/15/03 at 13:58 (121927)

hi i just had a guestion regarding my mri i had a nerve test and it proved positive for tts but the dr wont do the surgery since ihave rsd in that foot and he told me my mri was normal it says there are a few prominent veins, a mild t2 signal seen within the medial aspect of the lateral malleols likely representing tiny intraosseous ganglion cyst , and there is a tiny 7mm ganglion cyst on the medial side of the peroneal tendons at the level of the lateral malleolus, my dr tells me this is normal and that he cant do anything for me i guestioned him if the chronic pain i am having could be from the cortisone shots i had when i was treated for neuromas which i found out i dont have he said posibly so here i am back where i started 2 years ago what treatment do most people go through having tts but no surgery option? thanks marie c~ reno nv

Re: my mri report for tts

Dr. Z on 6/15/03 at 17:31 (121943)


You are in a tough situation. Most doctor feel that surgery on a patient with RSD is asking for additional more severe pain. Some doctors feel that surgery in an RSD patient is like a magnet, where ever you do the surgery the RSD follows. So what do you do.
The quick answer is pain management. I would consider the use of narcotics such as Fentanyl patches. Very important that you see someone with alot of experience with controlling pain. I wish I could give you a better answer. Some doctors recommend nerve stimulator implants. I have seen a few results that were only fair.

Re: my mri report for tts

Tammie on 6/15/03 at 18:50 (121949)

Hi, Tomorrow I will be getting the spinal stimulator to help with the RSD which has been out of control for so long that nothing seems to have settled it down. They are telling me it is my best bet on getting pain relief. On the foot that I had the pf and tts surgery it is now either purple or red hot it changes anytime it feels and it always is pain. I wish someone would have dx alot sooner and new the treatment for it. As now the specialist say I have a 50% or less chance of reduced pain. One more thing if anyone thinks they have RSD get in fast as it DOES spread! Early treated it can be controlled better. Tomorrow I will go for the trial surgery spinal stim. I hope I can help someone else by this. Talk soon.

Re: my mri report for tts

Pam S. on 6/15/03 at 21:29 (121960)

I am always troubled when I read posts such as yours. I do hope you both find help and relief. I really do not know how to advise you. It is overwhelming I am sure.

Can you all help us who might not understand. There seems to be three types of burning pain we all may have - TTS, PN or RSD. What symptoms distinguishes these syndroms from each other since burning is dominent in all three. For example, I think with RSD you have color changes Right? Do you have to have color changes or maybe sensitivity to touch with RSD. Do you not have color changes with PN...just burning pain? I hope this is clear.

I have TTS and have been to a pain clinic but the dr. said I did not have RSD. I am not sure on what grounds he used to rule that out. He actually did nothing for me because he thought I would be worse if he tried cortisone. I did not ask why. He just told me to stay on Neurontin and try a tens unit.

One could also have Raynauds which causes color changes especially in cold climates. I think that is usually in your hands.

I will say a little prayer for you both. Thx, pam

Re: my mri report for tts

Ed Davis, DPM on 6/16/03 at 23:44 (122071)


There is a fair amount of overlap but some general guidelines:

TTS: affects the sole of the foot only
PN: there are many kinds of PN, but one of the more common patterns has 'stocking' distribution affecting the top and bottom of the foot equally, but often strating with the toes and working upward
RSD: type 1 CRPS is another name; can cause burning over an area of variable size but also discoloration that is visible and temperature changes that can be felt with the back of your hand.


Re: my mri report for tts

Ed Davis, DPM on 6/16/03 at 23:45 (122072)


I hope all has gone wll with your procedure. I am familiar with a lot of success stories with that procedure and hope you will be one.