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PROMINENT SPURRING IN TALUS in XRAY. Due to OLD INJURY?

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My question is about an old injury to my right foot/ankle. Back in 1989 I twisted my foot/ankle in a fall from running. I was in the army at the time. I was sent to the clinic and it was wrapped in an ace bandage and I was told to elevate, take aspirin and stay off of it for three days. No x-rays were taken. I had to go back to the clinic to get crutches because I could not continue to put any pressure on my foot/ankle. It took about a week before I was able to even attempt to walk again without crutches. After the army I worked on a job where I was on my feet for seven hours a night five days a week. Over the years old patientI have still had complications with my foot/ankle. High heels are out of the question because any tilt in my foot hurts. Swelling occurs if I stand on it for too long. I finally had some x-rays taken and they showed "prominent dorsal spurring from the anterior process of the talus associated with a prominent appearing anterior calcaneal process. Findings could indicate fibrous tarsal coalition. I haven't had this type of problem with my left foot. My question is, is it more likely than not that the injury to my foot/ankle in 1989 caused the problems with my foot/ankle that I'm having today? I have uploaded some documents.

Category: Orthopedic Surgeon

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Category: Spine Surgeon
 19 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com

I have read your details with diligence.

Going through all details it looks that present pain and swelling is not due to your old injury.There may be some ligament problems which should be ruled by having a MRI of your foot.The tarsal coalition is one of the major cause of foot pain & this may be a cause for your foot pain and swelling.

You should consult to a podiatric doctor & should have a MRI investigation . Once you get the MRI you can upload the reports.

Hope this will help you.
Feel free to discuss further,
With best wishes.


Patient replied :

Another question. My primary care physician, who is a military doctor, says that I have arthritis in my right ankle. Is it LIKELY, or EVEN POSSIBLE that an old traumatic ankle injury caused the arthritis since it has bothered me continuously since 1989. The injury in 1989 is the only injury I ever had to my right ankle.


Hello.

Yes, this may be an arthritis of the ankle & this may result from an old injury. However, for development of arthritis various other factors may also be causative like heavy weight bearing on the ankle, repetitive injuries, hereditary predisposition,etc.

I hope this was helpful. Let me know if you have further queries.

Regards.


Patient replied :

The reason why I'm so focused on my right ankle/foot is that I injured it in the military and if the injury caused the arthritis in my foot/ankle, then the military is obligated to take care of the teatment for as long as I need it. The pain in my ankle/foot has always been an issue since the injury in 1989. I continued to run on it while I was in the military and I worked a job for 15 years old patientthat required me to stand fro 7 hours a night. The pain was tolerable, it has just gotten worse over the years. The pain gets worse the longer I stand on it. It swells and gets stiff sometimes. I don't know of anyone else in my immediate famly that has been diagnosed with arthritis. I'm just in my 40's. My 90 year old paternal grandmother is having problems with her legs aching. She worked until age 72. I have uploaded more documentation and I hope the information I sent you, the articles and x-ray results you have can help you determine if my arthrits was likely caused by my old injury than anything else. My prescriptions are Diclofenac Sodium 75mg 2 pills daily as needed for pain and inflammation and Gabapentin 100mg 3 capsules at bedtime. I also have high blood pressure and take Triamterene 75mg once a day. Both my sisters also have high blood pressure.
MOTHER Age 66
Alzheimers at 65
Type 2 Diabetes diagnosed in her 40's
High blood pressure diagnosed in her 40's
Lower leg amputation
Pack a day smoker since age 18 non drinker
FATHER Age 74
High blood pressure diagnosed in his 50's
Heart attack in his 50's
Stroke in his 70's
He worked until age 72
non smoker non drinker


Hello,
Thank you for the follow up and more details.
The issue is without seeing your MRI, and ruling out ligament problems, i can't comment on whether the injury is the primary reason for arthritis.
However with MRI if the ligament problems are ruled out, since you're just 40 and you have early onset arthritis, the old injury stands out as a primary cause. In fact post traumatic arthritis is similar to osteoarthritis, and may develop years old patientafter fracture, ligament sprain, or injury. Injured ankle has 7 times more propensity to develop arthritis earlier than a normal ankle. In fact after any such injury, body starts producing hormones, that lead to increased cartilage destruction, leading to arthritis.
So kindly get the MRI, to find out what is the primary cause.
Regards.


Dr. Mukesh Tiwari
Category: Spine Surgeon
Experience: 
Fellowship - Khandaka Hospital, Jaipur
Residency - MS, Rabindranath Tagore Medical College, Udaipur, 2000
Medical School, Internship - MBBS, SMS Medical College, Jaipur, 1995
Dr. Mukesh Tiwari and 4 other Medical Specialists are ready to help you

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