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  • Esacerbated Symptoms Post Steroid Injection

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    Old 01-19-2006, 09:18 AM   #1
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    Exacerbated Symptoms Post Steroid Injection (Ankle Joint)

    I have been working with a podiatrist for two months to find the cause of foot and ankle pain that has plagued me for 6-7 years. I do have a history of frequent ankle sprains and have personally referred to my right ankle as "weak" in the past.

    Initially, the podiatrist felt that my foot symptoms were consistent with a neuroma, and was pretty close to recommending surgery. However, I added that I also had pain shooting from mid-foot to each side of the ankle, and he recommended a bone scan to see if there was more to the story.

    The bone scan was positive. It showed mild uptake in both the right and left mid-foot, but severe abnormalities in the right ankle joint. As a side note, I should mention that he also ordered blood work to test for arthritis. The results indicated that I was undergoing "mild changes"...not enough to explain this level of pain and discomfort, much less give a diagnosis of arthritis.

    Feeling that it was possible I may have synovitis in that joint, he injected a stereoid into the joint seven days ago. He mentioned that, should the steroid not eliminate or help the symptoms, he would want to take detailed x-rays and, should he not find anything, he would likely order an MRI. I should note here that previous x-rays *were* performed before the bone scan, but were of the foot (as that's what I pointed to and said "Ow").

    I expected problems with the steroid injection in the first 24 hours (this, from past experience). However, in the first *72* hours post-injection, I was completely unable to bear weight on that joint. I kept it elevated and applied ice 20/20. Since that phase, I have had intermittent pain and a burning/ache that makes it difficult to put weight on the joint at times. I am also unable to walk for more than a few minutes without launching into a pronounced limp and feeling ankle instability and a burning pain. As a matter of fact, my foot and ankle symptoms are actually *worse* than before the injection. ???*confused*???

    I will visit with the podiatrist again in four days. However, I wanted to throw this thread out there to see if anyone has experienced anything similar - either with bone scan results - or a poor reaction to steroid injection (that lasted longer than 24 hours).

    I also don't know whether something such as a torn ligament would provide positive bone scan results...bone scans show increased *bone* growth or repair...having nothing to do with ligaments..........right?

    Last edited by findingmeg; 01-19-2006 at 10:22 AM. Reason: Edited to provide further detail

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    Old 01-24-2006, 07:46 AM   #2
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    Re: Esacerbated Symptoms Post Steroid Injection

    Hi everyone,

    I just thought I'd post an update on the post-steroid injection problem. I have discovered, after a follow-up visit to the podiatrist, that my problem is not in the true ankle joint. Apparently, it is in the subtalar joint. Which explains why the steroid injection didn't help.

    To explain why the steroid injection actually *hurt*, I was told that it's a condition called "post-injection flare"...the crystals in the steroid cause a crystal-induced synovitis in the joint that lasts anywhere from 24 to 72 hours. After the initial flare subsided, the pain I experienced the rest of the week was pain coming from the problem in the subtalar joint.

    I hope that this information is useful to others. Fortunately, such a post-injection flare only happens with 1% of the population, so it's unlikely to happen to you.

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