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Old 12-05-2009, 06:12 PM   #1
Gillian Steele
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Ankle Injury

Hi Guys

In September I had a Fulkerson's Osteotomy on my left knee, during my rehab period, my crutches splintered and I fell injuring my right ankle.

Below is the Bone Scan report, could you guys help me make some sense of this:

Bone Scan



Clinical History: Had left knee osteotomy in September. In late September she had a fall from her crutches sustaining an inversion injury of the right ankle. Persisting pain and swelling around the right ankle.



Report: The study was performed following administration of 840MBq of technetium HDP



The dynamic and blood pool images of the feet demonstrated hyperaemia around the right ankle particularly medially.



On delayed images was moderately intense osteoblastic activity in the tip of the right medial malleolus and along the medial aspect of the adjacent talus. There was mild diffuse increase in uptake throughout the right ankle. There was no focal uptake in the talar dome to suggest and osteochondral fracture. There was moderately intense osteoblastic activity in the left tibial tubercle at the surgical site and degenerative change in the left patellofemoral joint.



Conclusion



The appearance is consistent with significant ligamentous injury in the vicinity of the right medial malleolus and adjacent talus possibly with an impaction type injury. A small invulsion fracture of the tip of the medial malleolus or talus is not excluded particularly in view of the small bony fragment in this area on CT Scanning. No evidence of osteochondral fracture near the talar dome. Probable traumatic arthropathy of the right ankle. Changes in the left tibial tuberosity consistent with recent surgery. Mild degenerative change in left patellofemoral joint.
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Old 12-06-2009, 01:20 PM   #2
Steven Low
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Re: Ankle Injury

Quote:
Originally Posted by Gillian Steele View Post
Hi Guys

In September I had a Fulkerson's Osteotomy on my left knee, during my rehab period, my crutches splintered and I fell injuring my right ankle.

Below is the Bone Scan report, could you guys help me make some sense of this:

Bone Scan

Clinical History: Had left knee osteotomy in September. In late September she had a fall from her crutches sustaining an inversion injury of the right ankle. Persisting pain and swelling around the right ankle.

Report: The study was performed following administration of 840MBq of technetium HDP

The dynamic and blood pool images of the feet demonstrated hyperaemia around the right ankle particularly medially.

Increased blood flow on the medial side of the foot.. probably for healing.

On delayed images was moderately intense osteoblastic activity in the tip of the right medial malleolus and along the medial aspect of the adjacent talus. There was mild diffuse increase in uptake throughout the right ankle. There was no focal uptake in the talar dome to suggest and osteochondral fracture. There was moderately intense osteoblastic activity in the left tibial tubercle at the surgical site and degenerative change in the left patellofemoral joint.

Osteoblasts lay down bone. In this case for healing along the inside of the maleolus (bump on the inside of the ankle) which is the tibia and the talus of the ankle under that.

No sign of fracture which is good.

Small amounts of degenerative change up at the knee though, but there is bone healing there.


Conclusion

The appearance is consistent with significant ligamentous injury in the vicinity of the right medial malleolus and adjacent talus possibly with an impaction type injury. A small invulsion fracture of the tip of the medial malleolus or talus is not excluded particularly in view of the small bony fragment in this area on CT Scanning. No evidence of osteochondral fracture near the talar dome. Probable traumatic arthropathy of the right ankle. Changes in the left tibial tuberosity consistent with recent surgery. Mild degenerative change in left patellofemoral joint.

Probably tore or severely strained some of the ankle ligaments and everything we went over before.
Basically, you're probably gonna go in for some physical therapy for this.

Nothing that major.. classic inversion sprain. Although I'm surprised there was no analysis of the lateral malleolus
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Old 12-07-2009, 01:16 AM   #3
Gillian Steele
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Re: Ankle Injury

Thanks for explaning Steve, really helped
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Old 12-13-2009, 02:03 AM   #4
Gillian Steele
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Re: Ankle Injury

Hi Steve

I had some physio on my ankle, he's been doing some releases on it, but at the moment, its at the point where it feels like it wants to crack but it can't just getting so sore!
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Old 12-13-2009, 10:17 AM   #5
Steven Low
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Re: Ankle Injury

PT should be focusing on reducing inflammation through massage, rest, diet, perhaps some ice, compression, etc.

Once it starts going down start working on range of motion. After inflammation is mostly gone, start strengthening work

That's fairly normal that there's going to be tight muscles there and it wanting to crack.
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