Have Had Stabbing Buttock And Ankle Pain. MRI And X-ray Normal. Cause?

Posted on Tue, 17 Sep 2013

Question: Hi. I have had buttock/hip/stabbing ankle pain for going on a year now. Two mri's and an xray have been negative for problems. Any idea what could be causing this?
Some more information: it could be related to a fall, but not certain. It seems to get better at times, for maybe a few weeks, but then flares back up. The buttock pain is constant, but sometimes not very severe. The stabbing ankle pains come on every few weeks. They are a 15 out of 10 pain! The stabbing pain is in the back of the ankle, what I believe to be the achilles. I also have occasional numb big toe and maybe the 2nd toe. I go to physical therapy off and on and sometimes I seem to get relief and other times not. I am currently taking Aleve, but not sure if it is helping much.

Answered by Dr. Kulsoom Qureshi (3 hours later)

Brief Answer:
Few suggestions about the possible cause!

Detailed Answer:
Hi XXXXXXX
Thanks for discussing your problem with us.
Since your MRI & X-Rays are negative for any obvious or gross lesion, so, this pain is not likely to be related to any joint or muscular problem.
I have few other differentials that may have caused this pain:
1. Nerve compression.
2. Any gynecological problem ( relatively unlikely as this often causes pain on medial side of the thigh.
3. Vitamin-D deficiency.
4. Sometimes this type of pain is seen in patients with undiagnosed or poorly controlled diabetes or in those with high uric acid levels.
So, I suggest (if you have not checked already) that you should check your blood sugar, uric acid & vitamin-D levels.
Also, it is advisable that you should have an appointment with a neurologist to rule out nerve compression.
Hope I have given you some helpful clues.
Wish you good health.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kulsoom Qureshi (23 minutes later)

Thanks for the response. I have ruled out diabetes. I also had a blood workup done by a rheumatologist. It did show my vitamin d was a bit low, but he said that it probably would not be causing the pain. I did start taking a vitamin d supplement. He also said my protein was a bit high. Other than that, I think everything was fine. He did not mention anything about uric acid. There maybe a correlation between my periods and worsening pain, but not totally sure. My physical therapist thinks it is something to do with my l5/s1 area of my back, but two mri's have been negative, so not sure if that is still a possibility. I am wondering if it is something with my sacrum and/or si joint. At this point I feel doomed as far as anyone finding out the actual spot of nerve compression. I have been to a neurologist, which seemed to be a waste of time and money, and he wanted me to try taking Cymbalta, which I am not willing to try, at least not at this point. i am still hoping that someone can locate the actual point of compression or entrapment, but not sure if that is possible.

Answered by Dr. Kulsoom Qureshi (2 hours later)

Brief Answer:
Neurologist are the people to locate nerve problem

Detailed Answer:
Hi XXXXXXX
Thanks for your reply.
After reviewing your whole story, the only suggestion I can give you is to follow your Neurologist as they are the ones who can locate the problem in your case, even if you don't like this opinion. You may try another doctor for a second opinion.
Secondly, have a Gynecological opinion as well, if you have slightest doubt that this could have a relation with your periods.
Wish you good health.
Take care.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar