Hello- I am such a nervous wreck after reading the MRI report of my ankle, I'm about 10 weeks post-sprain. My ankle is so sore still, and not functioning properly. Here's what the MRI SAYS:
1. Full thickness tear or ATFL
2. Partial tear of superomedial ligament component of the Spring ligament complex.
3. Large ankle effusion
4. no indication of tendon tear, peroneal tear or subluxation (which is very interesting because that's the ONE symptom my Dr and I can feel)
5. increased space between the tibia and fibula, suggesting a Syndesmosis sprain
I have the follow up with my OS next week but I am just a worrier. Has anyone had these symptoms? Was there surgery involved?
The ATFL is the Anterior Talo-fibular ligament, the most common site of injury in an ankle sprain. The syndesmotic ligament connects the two bones in the lower leg, the tibia and the fibula. Effusion basically just means swelling.
So you have a few torn ligaments. They may require surgical repair, or they may not. The surgery isn't fun, but it's usually successful.
About the peroneals: It could be the MRI is wrong or was misread. It happens much more often than many people realize. My ankle MRI missed a significant problem, and my treatment was delayed for three months as a result.
Or, it could be that your peroneals are OK, and the pain there is just the result of compensating for the damaged ligaments. If pain behind your ankle appeared only when you started trying to walk again, that could be why. I developed pain behind my ankle from abnormal gait. I found that massaging the peroneal muscles (along the fibula) helped relieve it.
This will be a long recovery. You will need patience, and it's very important to get a consultation with a good orthopedic surgeon, preferably one who is a board-certified foot and ankle surgeon.
Please let us know how the appointment next week goes, and do ask if you have other questions.
My appointment with the OS was this morning and I am SO completely frustrated- after I left the Dr I got in my car and was crying like a baby.
The Dr said the MRI was 'normal' (normal in that we knew it was a bad sprain PLUS a high ankle sprain). I asked him why the subluxing peroneals were discounted on the MRI and he said maybe they aren't subluxing. Ok- wait a minute- this is the Dr that put me in a cast for 6 weeks because my tendons were subluxing. I asked for an MRI before casting and he said no.
His Rx is 6 weeks of Physical Therapy- whaaaa? I've been in this aircast boot for 11 weeks and NOW we are starting PT?? Why didn't we do this say..oh..8-9 weeks ago?? I'm just in tears- I feel like the pain and discomfort I have been through have been for nothing.
Needless to say- I am switching Drs..I made an appointment with a Foot/Ankle specialist (this OS was a general/sports med guy). I hate to start over with a new Doc but I think it's for the best.
stephanie, did you get your mri after being in the cast? if so, the peroneals may have healed down and do not sublux anymore. the rest of your mri is basically a grade 3 ankle sprain and high ankle sprain. depending on your activity....athlete, just normal person, etc. will determine surgery. prob not though. pt definitely is right path right now. hope you get more answers from foot doc. but start pt definitely.
Shelley is right in that the peroneals may have scarred over with the immobilization. As I'm sure you know, when subluxation occurs the tendons are jumping out of their groove. Before my peroneal surgery mine would do this occasionally and pop back in place. You are perfectly still during an MRI so as long as the tendons had not popped out and stayed out, the MRI would not have shown subluxation. Mine didn't and I still had subluxation from time to time.
While my MRI did show one peroneal was torn, actually both were and it wasn't visible on the MRI. So, the peroneals are notorious for hiding tears as one lies directly behind/beneath the other and aren't always easy to visualize. Also, the MRI report only reported tendinosis but my Foot and Ankle doc clearly saw the tear. Going to a foot and ankle specialist is the best thing to do at this point, IMO.
Let us know how you are doing. Welcome to the Foot Board!
I really appreciate the replies! I had my appt with the foot and ankle OS yesterday amd it went very well. He gave me two options, 1- do surgery now. 2- go with a 8 week regimen and then if that fails do the surgery. He said it's about 50/50 if it will work- but hey- I'm going to give it all I've got!
The peroneals are definitely subluxing- I can move my foot a certain way and they jump out. He said I needed three things- 1- a Brostrom repair, 2- debriedment and cleaning up, and 3- peroneal fixing (groove deepening?). I'm really nervous about having all this done- so hoping for the best with the next 8 weeks.
Yesterday I got a cortisone injection- um...ouch! Today it still hurts at the inj site. I'm on an oral steroid for 5 days and Piroxicam from then. I start PT next week, and do ice massages at home 3x a day for the 8 weeks. I'm also in a lace up brace.