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What Does My MRI Scan Test Report Indicate?
Question: Dear Dr.
Good day!
This is Dr. XXXXXXX I have a 19 years old female patient who twisted her right ankle (exact duration is not known-couple of months probably) and afterwards she is complaining of pain in her right ankle.
Clinical Examination:
Height: 154.5cm, Weight: 57.1kg, Pain: 2, Mild swelling antero-lateral aspect -tenderness, range of motion is good but painful specially pronation and supination.
MRI right ankle shows the following:
The al ignrnents of the bones are normal.
The articular margins at ankle joint appear smooth and intact.
The visualized part of tibia appears normal with normal dark cortical line and normal marrow signals.
Minimal fluid noted in the anklejoint.
The neuro-vascular structures appear normal.
Diffuse T2 and STIR hyperintensity seen in the deep fibers of the deltoid ligament, anterior and posterior talofibular ligaments likely suggestive of Grade 1 sprain.
The medial and the lateral, and the posterior and the anterior group of muscles with the tendons in visualized extent appear normal.
Diffuse STIR hyperintensity of the sinus tarsi seen possibly? sinus tarsi syndrome.
No obvious retrocalcaneal bursitis.
No obvious abnormality in kager's fat pad.
No obvious fluid collection / gross focal lesion in and around the Achilles tendon.
Subcutaneous edema noted around the ankle and heel
Impression:
Diffuse T2 and STIR hyperintensity seen in the deep fibers of the deltoid ligament, anterior and posterior talofibular ligaments likely suggestive of Grade I sprain.
Minimal fluid in the ankle joint.
Diffuse STIR hyperintensity of the sinus tarsi ?sinus tarsi syndrome
Diagnosis:
Sprain Of Calcaneofibular Ligament Of Right Ankle, Sequela
Syndesmotic injury right Ankle
Proposed management plan:
Repair Secondary disrupted ligament, e.g. Watson XXXXXXX procedure.
It is requested to please give your expert opinion on the case for the treatment plan for the above mentioned case and if the above mentioned proposed plan of management is apt and is in the best interest of my patient. Please also clarify why conservative management is not an option for this young lady (like physiotherapy, movement restriction and analgesia).
Waiting for your kind reply.
Good day!
This is Dr. XXXXXXX I have a 19 years old female patient who twisted her right ankle (exact duration is not known-couple of months probably) and afterwards she is complaining of pain in her right ankle.
Clinical Examination:
Height: 154.5cm, Weight: 57.1kg, Pain: 2, Mild swelling antero-lateral aspect -tenderness, range of motion is good but painful specially pronation and supination.
MRI right ankle shows the following:
The al ignrnents of the bones are normal.
The articular margins at ankle joint appear smooth and intact.
The visualized part of tibia appears normal with normal dark cortical line and normal marrow signals.
Minimal fluid noted in the anklejoint.
The neuro-vascular structures appear normal.
Diffuse T2 and STIR hyperintensity seen in the deep fibers of the deltoid ligament, anterior and posterior talofibular ligaments likely suggestive of Grade 1 sprain.
The medial and the lateral, and the posterior and the anterior group of muscles with the tendons in visualized extent appear normal.
Diffuse STIR hyperintensity of the sinus tarsi seen possibly? sinus tarsi syndrome.
No obvious retrocalcaneal bursitis.
No obvious abnormality in kager's fat pad.
No obvious fluid collection / gross focal lesion in and around the Achilles tendon.
Subcutaneous edema noted around the ankle and heel
Impression:
Diffuse T2 and STIR hyperintensity seen in the deep fibers of the deltoid ligament, anterior and posterior talofibular ligaments likely suggestive of Grade I sprain.
Minimal fluid in the ankle joint.
Diffuse STIR hyperintensity of the sinus tarsi ?sinus tarsi syndrome
Diagnosis:
Sprain Of Calcaneofibular Ligament Of Right Ankle, Sequela
Syndesmotic injury right Ankle
Proposed management plan:
Repair Secondary disrupted ligament, e.g. Watson XXXXXXX procedure.
It is requested to please give your expert opinion on the case for the treatment plan for the above mentioned case and if the above mentioned proposed plan of management is apt and is in the best interest of my patient. Please also clarify why conservative management is not an option for this young lady (like physiotherapy, movement restriction and analgesia).
Waiting for your kind reply.
Brief Answer:
Old injury is less likely to heal conservatively.
Detailed Answer:
Hello,
Thanks for posting your query.
I have gone through the details of the query. In young patients the ligament injury can heal conservatively with brace, avoiding weight bearing and physiotherapoy. But there is a minimal fluid in the joint suggestive of an inflammation and if it is more than 6 weeks old injury then conservative treatment is not likely to help her as these ligaments have a less vascularity. A fresh injury can heal with rest but not an old injury with inflammation.
A surgical repair will be best in this case as proposed.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Old injury is less likely to heal conservatively.
Detailed Answer:
Hello,
Thanks for posting your query.
I have gone through the details of the query. In young patients the ligament injury can heal conservatively with brace, avoiding weight bearing and physiotherapoy. But there is a minimal fluid in the joint suggestive of an inflammation and if it is more than 6 weeks old injury then conservative treatment is not likely to help her as these ligaments have a less vascularity. A fresh injury can heal with rest but not an old injury with inflammation.
A surgical repair will be best in this case as proposed.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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