Question
I sprained my left ankle (ankle rolled outward over the pine cone...) about 3 months ago and after going to physical therapy for a month or so, it was better.  However, I tried to avoid things like running and swimming, leaving only bicycling.

At some point in the last month, I seem to have perhaps reinjured the ankle.  I got an MRI and was wondering if you might give me your opinion and what I should be doing to heal it up (or if I can get some treatment to accelerate it).  Prior to the MRI, the doctor had prescibed me naproxen.  I've also been doing contrast therapy on it.  The text below is from the MRI.  No too sure what it all means.

Collateral ligaments: There is a thickening with increased signal intensity of the anterior talofibular, particularly at the fibular insertion compatible with a probable chronic sprain with high grade disruption.  Correlation with anterolateral impingement would be recommended.  There is also mild diffuse thickening of the calcaneofibular ligament and to a lesser extent the posterior talofibular ligament.

Flexor Tendons: A small amount of fluid is present in the tibialis posterior tendon sheath at the posteromedial malleolus.  This may represent mild tenosynovitis or fluid arising from the ankle joint.  The tendons are intact without tear or subluxation.  There is a moderate sized accessory ossification centered in the navicular.  There is, however, no bone marrow edema.  There may be minimal increased signal intensity within the tibialis posterior tendon near the navicular insertion but this could be artificial in nature.  This could represent minimal tendinosus.

Thanks for any help/recommendations that you can give me.

Answer
This Chicago & Elmhurst Podiatrist says.......

Dear Daniel,

This means nothing if your ankle keeps improving.
The MRI suggests an injury and healing of the ankle ligaments.
I like physical therapy with ultrasound of the ankle. Also do strengthening, range of motion-but don't over stretch for the first 3 months, and lateral running exercises to prevent future sprains. See a good orthopedic podiatrist and see if orthotics may also help decrease the chance of future sprains.
See our website at AnkleNFoot.com for examples of ankle braces-which would be wise to wear 6-8 months and maybe longer-depending on the injury follow up
Hope This Helps
Good Luck!

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

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