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Q. I need a second opinion regarding my MRI ankle reports.

Answered by
Dr. Lokesh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 08, 2017 and last reviewed on: Mar 08, 2021

Hello doctor,

Almost two months back, I twisted my ankle around ninety degrees inward. It caused my ankle to pop very loudly and I had to limp for several minutes. It instantly began to swell and within 10 minutes it was three times the normal size. Within three days, the swelling spread and my entire foot began to bruise. However, the physician still claimed it was a sprain. After two weeks of no improvement, they claimed it was not a sprain and were not sure what the issue was. I was then referred to an orthopedician and he requested an MRI. It is still is not possible to put any weight on my foot and the pain medication that I have been prescribed is barely working. I would like to have a second opinion. I have some images from the MRI posted and more images available upon request. The images posted were the ones that piqued my interest and seemed likely to point towards whatever the injury. Previously, I was taking Naproxen 500 mg, Tramadol 50 mg and Norco 5/325 mg for the same issue. Currently, I am taking Norco10/325 mg, Vistaril 25 mg and Ibuprofen 800 mg.

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#

Hi,

Welcome to icliniq.com. 

  • If your injury and pain are not getting better, then I think there is a cartilage injury of the ankle joint.
  • If you can upload your MRI images and the report, then I feel I can pick up the cartilage lesion or any other abnormality and suggest you an appropriate treatment for it. So, upload your MRI images as soon as possible and then we can advise you the further line of treatment.
  • Till then, I suggest you wear an ankle stirrup air cast for support and continue anti-inflammatory medicines like Naproxen.

Differential diagnosis:

1. Ankle pain.
2. Cartilage injury.
3. Bone edema.

Regarding follow up:

Revert back with the MRI images to an orthopaedician and traumatologist online.---> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

Thank you doctor,

I have uploaded the MRI images.

#

Hi,

Welcome back to icliniq.com.

From the images (attachment removed to protect patient identity), cannot see a big section of bone edema. There is a contusion of the bone. I cannot see all the ligaments in the images that you have uploaded. This type of injury usually takes about three to four months to get better from the time of injury. I suggest you take injection Zoledronic acid 5 mg intravenously over 45 minutes stat dose once. With this injection, you need to take tablet Paracetamol 500 mg, two tablets about five minutes before taking the injection. Please consult a specialist doctor, discuss with him or her and take the medicine with consent. Before taking the injection check for the serum creatinine levels. Your serum creatinine levels should be normal and you should not be allergic to this injection.

I also suggest you take tablet Shelcal (combination of Calcium carbonate and Vitamin D3), two times a day (in the morning and at night) for two months along with tablet Vitamin D 60K units once a week for eight weeks, tablet Vitamin C 500 mg once a day for one month, tablet Ibuprofen 400 mg once in the night for 15 days after food and tablet Rabeprazole 20 mg once at night time for 15 days after food. You need to wear the air cast ankle stirrup all the time for one month. You can do a sitting job. You should avoid running or jumping. You should avoid using a two-wheeler vehicles. Also, you avoid going to a gym. You will get better in less than a month if you take the above injection, which is very potent for reducing bone edema.


Probable diagnosis:

Ankle twisting with bone edema in the talus and tibia.

Regarding follow up:

For further information consult an orthopaedician and traumatologist online.---> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist


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