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Foot & Ankle Problems Message Board


Foot & Ankle Problems Board Index


I sprained my right ankle 7 weeks ago when I fell while walking down my basement steps. I got to the last step, stepped down on my basement floor with my right foot, foot went inwards, felt snap and pain, fell down with foot and leg underneath me. I got up, walked around, ankle felt weak and unstable, but pain was minimal at the time. My ankle swelled up and bruised later, and became more painful. I could not walk without a brace or crutches. I even wore the brace at night because I could feel movement in my ankle. Went to the family doctor five days later, and had an xray. Xray came back good. No fractures and no dislocations. Weeks go by - swelling is down but there is pain and limited mobility in my right ankle. My foot looks crooked - the left side is in an upwards position and the right side a downwards position. There is definitely a difference between the left foot and the right foot. I walk with a steppage gait with my right foot because mostly the outside part of my foot hits the ground. I go to orthopedic foot doctor. They send me to physical therapy, and tell me to wean myself off of crutches and brace. I try to do that and my ankle begins to swell and cause me pain just as if I sprained it yesterday. I go back to orthopedic doctor, and I beg for an MRI.

MRI comes back saying I have focal bone marrow edema present involving a small portion of the medial aspect of the body of the talus, which probably represents bone contusion secondary to inversion injury.

AFTL ligament is normal, but enlarged and edematous, representing strain or partial tear. CFL ligament is probably intact, and is normal in course.

Small amt of fluid in peroneal tendon sheath. No peroneal tendon tear, subluxation, or significant tendinopathy demonstrated.

Increased signal present in the deep deltoid ligament region, indicating edema related to the acute injury or intrasubstance degeneration of the deltoid. Deltoid is intact.

No medial tendon tears present. Some signal in Achilles tendon which is common finding on ankle MRI examinations without tendon enlargement or tears.

Small ankle joint effusion. No loose bodies demonstrated. No talar dome osteochondral defects.

What's all this medical jargon mean? Can somebody explain what could cause my ankle to be crooked if there is no dislocations in the ankle joint? Can a muscle, tendon or ligament atrophy and pull my foot into an incorrect position? It's very noticeable - there is a huge difference between the left foot and right foot. I cannot move my foot up and down or side to side. When I do try, my foot goes into a violent spasm.
Your ankle tilt could be the result of weakness in the ATFL (That's Anterior Talo-Fibular Ligament. (try to find a picture of ankle anatomy so you can see where it is.) The MRI says it may be partially torn or weakened.

The bones are held in place by ligaments on all sides. If the ones on one side are too weak, bones might tilt out of position.

Your talus, that's a bone in your ankle, is bruised. Not broken, but that'll still hurt a lot. Your deltoid ligament (another one on the outside of the ankle) is also damaged to some extent.

Bottom line, you shouldn't be walking on this foot. You might or might not need surgery depending on how healing progresses.
Crooked Ankle-I'm sorry to hear of your injury. It is painful, I know. I've torn 2 ligaments and had surgery to repair them. As far as your MRI, as the others stated, there is a bruise on your talus or ankle bone and the ATFL (anterior talofibular ligament) might be torn. They think the CFL (calcaneofibular ligament-attaches to your heel) is okay. The CFL is often times poorly visualized on MRI. My MRI stated that mine "appeared" to be intact too, but also said it couldn't see it well. My doctor got into my ankle and found both the ATFL and the CFL were torn. These 2 ligaments along with the PTFL (posterior talofibular ligament) make up the lateral (outside) ankle ligaments. The deltoid ligaments are located on the medial (inside) aspect of your ankle. It is sort of a fan shaped ligament. I think the MRI stated yours was okay. It also sounds like you have swelling which is normal. I agree with Jane in that you shouldn't be walking on this ankle until it is properly diagnosed and a treatment plan is in place. You don't know what the damage is now or what it might become without these things. Plus, with the deformity you are describing, your ankle warrants attention by an ankle specialist. Make an appt asap! Good luck and let us know what happens!
Hi there,
Sprained ankles are no fun and take a long time to heal.

[COLOR="Blue"]MRI comes back saying I have focal bone marrow edema present involving a small portion of the medial aspect of the body of the talus, which probably represents bone contusion secondary to inversion injury.
[/COLOR] This is saying basically there is swelling and a bone bruise. Think of an apple getting bruised. My daughter had this finding on her MRI and she was told to not do gymnastics for a few weeks, but she was still walking.

[COLOR="blue"]AFTL ligament is normal, but enlarged and edematous, representing strain or partial tear. CFL ligament is probably intact, and is normal in course.[/COLOR] The AFTL is the one most often torn and damaged first. It looks like you strained or tore it partially, like a grade 2 sprain.



[COLOR="blue"]Small amt of fluid in peroneal tendon sheath. No peroneal tendon tear, subluxation, or significant tendinopathy demonstrated.[/COLOR] Peroneal tendons are on the outside of your ankle and run around your ankle bone. It's good yours are not torn. Probably inflamed. I was told by my dr. that after they can take over for the ligaments when they are stretched out or, in my case, ruptured. NO tear is good though, fluid there can cause pain, I'm sure.

[COLOR="blue"]Increased signal present in the deep deltoid ligament region, indicating edema related to the acute injury or intrasubstance degeneration of the deltoid. Deltoid is intact.[/COLOR] Can't comment here because I don't have issues in this part of my ankle, so not familiar.

[COLOR="blue"][No medial tendon tears present. Some signal in Achilles tendon which is common finding on ankle MRI examinations without tendon enlargement or tears.
/COLOR] Can't comment here either.

[COLOR="blue"]Small ankle joint effusion. No loose bodies demonstrated. No talar dome osteochondral defects.[/COLOR] You have swelling in the ankle. And a VERY good sign that there are no talar dome defects or loose bodies in there. You don't want that.

[COLOR="blue"]What's all this medical jargon mean? Can somebody explain what could cause my ankle to be crooked if there is no dislocations in the ankle joint? Can a muscle, tendon or ligament atrophy and pull my foot into an incorrect position? It's very noticeable - there is a huge difference between the left foot and right foot. I cannot move my foot up and down or side to side. When I do try, my foot goes into a violent spasm. [/COLOR] If you don't move your ankle around a lot, then you can lose range of motion. See what your dr. says after the MRI. Mine made me wait 3 months after my ankle injury before he would even do an MRI, so it takes awhile. Ankle sprains can be tougher to heal than a break.

See an ankle dr. and see what he says. 7 weeks is still really early to be fully healed from a sprain.





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