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Sports Medicine

Ankle injury...

02/23/2009

Question:

I have sprained my ankle initially 1.5 years ago. Since then i have done the ankle a couple of more times. At the moment i have ankle pains and i assumed them to be as a result of scarring tissues and impingement. I saw a specialist recently and after looking at the MRI report he suggested that i have had cartilage loss and that my age of the joint is 35 - 40 years old(im 21 at the moment). Interestingly he said the cartilage loss has been happening for about the last 4-5 years. know how can i be sure if i have a cartilage loss and it doesnt make sence that i had these losses happening over the last 4-5 years whilst i had the injury for only 1.5 years. Can cartilage loss occur cause of series of sprains and impingements.

Answer:

Cartilage loss can certainly occur following one or more trauma(s) to a joint, which can be referred to as "post-traumatic arthritis."

An ankle MRI scan - if performed without contrast injected into the joint - is good but not great at depicting cartilage detail, for which reason it may be difficult to state with certainty if - or how much - cartilage loss has actually occurred. I am not aware of how an MRI scan can distinguish between cartilage loss which began 1.5 yrs. ago vs. cartilage loss which had begun longer ago. If not already done (although your treatment will likely remain the same regardless of the results), your physician may wish to consider X-rays of both ankles - for comparison purposes - performed both with and without weightbearing - to determine whether your ankle joint spaces are more narrow on the injured compared to uninjured side, as well as whether weightbearing narrows the spaces more on your injured compared to uninjured side.

If you are certain that prior to your ankle sprain 1.5 yrs. ago, you had never sprained that ankle, and never had ankle symptoms of pain, stiffness, swelling, locking, nor giving way, it seems unlikely at age 21 that you were losing cartilage from your ankle joint with no associated cause nor symptoms.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University