Joe A Shaw PA-C - 4/2/2008

Question
Hi doctor
i would like to know your opinion about my daughter condition management:
she is 11 years old, free from any disease & not treated from any condition, she plays sport (ping pong) regularlyone hour four times / week, she suddenly complaint (while she was at home) of pain in the Rt ankle with click sound on movement ( noconsistant)this was about one month ago the pain is still present , it's present with movement & after long walk & increases when she start walking after a period of rest, she stopped training since the star of the condition.  An MRI was done, the diagnosis was grade IIA osteochodral lesion of the right medial talar dome.some doctors advice rest & follow up , other adviced surgery & other adviced her foot to be put in bandage or plaster.
What is your advice?
Thanks

Answer
Salma,
That reminds me of watching the weatherman for the wknd...where he puts a picture up of some clouds, rain, lightning bolt, and the sun peeking through...no matter what he is pretty much covered!

And really all 3 of these things are appropriate...it really just depends on how much pain she is in and how it effects her quality of life as to how aggressive I would be. I have a child and I would do everything possible before having surgery...esp for something like this (ie non-life threatening)
So I would start w the rest and or brace/bandage first with follow ups...and try that for a while...then if thats not helping and it's getting worse then you can look at the surgery option..then I would get second opinion (specifically about the surgery) I personally would only go with a pediatric orthopedist...who does/sees a lot of feet/ankle problems.