Help with MRI report- ankle sprain - Foot Problems Message Board

StephanieBun · 07-11-2009, 09:01 PM

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?

janewhite1 · 07-12-2009, 07:16 PM

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.

StephanieBun · 07-14-2009, 01:56 PM

Thanks for the help Jane! I appreciate it.

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.

janewhite1 · 07-14-2009, 08:59 PM

Well, with a severe ankle sprain, several weeks of immobilization followed by PT might just be exactly what you need.

Still, the uncertainty is not good, and another consultation can't hurt.

How is it feeling these days? Are you able to walk well in the boot?

shelleybutn · 07-16-2009, 02:40 PM

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