I sprained my ankle running about five months ago (December 9th). X-rays, both the day of, and four weeks after, we’re negative for fractures. I had an MRI on February 19th (results below). I’ve been doing very disciplined PT and haven’t ran since the sprain. I’m still having significant swelling and some instability and pain when walking. Pain has improved a bit, but the swelling very minimally. My orthopedist keeps saying to give it more time. I’d appreciate another perspective. Thanks!
FINDINGS: Comparison is made to plain film radiographs of the ankle
which demonstrated significant soft tissue swelling overlying the
lateral malleolus on the examination from 12/9/2018.
Vitamin E tablets were placed overlying the extensor digitorum longus
and brevis tendons, along the posterolateral aspect of the ankle, and
along the medial aspect of the ankle.
The anterior talofibular ligament is intact although the ligament is
somewhat thickened see image #15 from series 7. The posterior
talofibular ligament and the calcaneofibular ligament image in a
normal fashion. The anterior inferior and posterior inferior
tibiofibular ligaments and the interosseous membrane image in a normal
There is thickening and increased T2 signal involving the more
posterior component of the deltoid ligament see image #13 from series
7 and image #16 from series 6. This affects the region of the
tibiocalcaneal the posterior tibiotalar ligaments. The spring ligament
is apparently intact.
There are normal signal characteristics within the tibialis posterior
tendon although there is a small amount of fluid signal within the
tendon sheath. This is demonstrated on images #7 and #8 as well as
image #17 from series 8. There are normal signal characteristics
within the flexor hallucis longus and flexor digitorum longus tendons.
There also are normal signal characteristics within the peroneus
brevis and longus tendons. There is a retromalleolar positioning of
the peroneus longus and brevis tendons. The peroneus brevis tendon is
positioned somewhat laterally relative to the peroneus longus tendon.
The usual positioning is immediately posterior to the peroneus longus
tendon. This is of questionable clinical significance.
The talar dome images in a normal fashion without discrete
osteochondral lesions. The fat within the sinus Tarsi is Maintained.
This examination is negative for subtalar tarsal coalition.
The plantar fascial and Achilles tendon insertion site image in a
1. The patient likely sustained a sprain of his anterior talofibular
ligament. There is mild thickening of the ligament but without
disruption. On occasion granulation tissue along the healed anterior
talofibular ligament may be associated with an anterior lateral
impingement syndrome. In this case the ligament is fairly uniform in
thickness without replacement by granulation tissue.
2. There also are findings suggesting a prior sprain along the more
posterior aspect of the deltoid ligamentous complex.
3. There is increased fluid signal intensity within the tendon sheath
of the tibialis posterior tendon may be a manifestation of
4. This examination is negative for an occult fracture of the ankle
or an osteochondral lesion.