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Equinus of unknown origin

Posted by josh s on 10/02/03 at 17:51 (131989)

Hey docotors,

I've posted here from time to time the last few years. I've gotten alot of help from Ed and Z, hoping to get a little more.

Bilateral ankle equinus. Approx. 4 degrees dorsiflexion. Hard end feel. Severe inversion sprains both ankles; left, age 12; right, age 19. Rearfoot varus. Stress lateral x-rays appeared to show bone on bone contact on right foot, small (approx. 2 degree) gap on left. Does not appear to be spurring as in classic impingement exostosis. No pain in anterior ankle. Symptoms are in feet due to compensation for equinus. 30 years old. I have a good pod with great bedside manner who seems to think either it is simply the geometry of my ankle joints (as per Root, et. al. describing articular variation where there is less space between talar neck and tibia) or some kind of blockage caused by scar tissue from sprains, or spurring not shown on x-ray.

I had an MRI recently but the report did not touch on this subject, though the MRI order asked for it.

I would really like to find out what the cause is and learn of surgical options. It's been two years since the stress x-rays and ten since I started stretching daily (no wonder I never saw any progress). Any suggestions on who I could see? I live in SE Ohio.

Thanks in advance.


Re: Equinus of unknown origin

Ed Davis, DPM on 10/03/03 at 18:47 (132105)

The impingement of the neck of the talus on the tibial plateau is the most likely culprit in the equinus. If this is indeed the case, removal of some of the bone on either side can significantly improve range of motion. Does your ankle still turn easily?

I am not too familiar with providers in your region but Gerard Yu, DPM who teaches at the podiatry school in Cleveland is well trained and may be a good person to see.

Re: Equinus of unknown origin

josh s on 10/06/03 at 15:42 (132474)

Thanks Dr. Ed, I'll check out Dr. Yu