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Sports Medicine

understanding an ankle MRI

10/17/2011

Question:

Question: I just got the results of an MRI of my right ankle:

Findings: Focal high-grade chondromalacia measuring approximately 7 x 5 mm along the lateral aspect of the talus with underlying subchondral bone marrow changes and cortical irregularity, series 2 image 7 series 4 image 14, compatible with underlying osteochondral lesion. No evidence of unstable fragment. Remainder bone marrow and muscle signal characteristics are within normal limits. Moderate joint effusion extending into the subtalar joint without discrete loose body. Medial and lateral collateral ligaments are intact. Mild circumferential fluid surrounding the peroneal longus and posterior tibia tendon compatible with underlying tenosynovitis. Normal tendons. Borderline 5 mm thickening of the medial band of the plantar fascia with underlying calcaneal enthesophyte formation may represent underlying plantar fasciitis.

Impression: 1. Osteochondral lesion along the lateral talus 2. Moderate effusion without loose bodies 3. Mild peroneal longus and posterior tibia tenosynovitis 4. Borderline plantar fasciitis

I was told by the orthopedist who ordered the MRI that I should make an appointment to see a foot and ankle specialist and was given the names of 4 doctors. I have been unable to talk with the orthopedist since and none of the foot and ankle specialists are able to see me until the middle of November, a wait time of over 6 weeks.

I`ve been given a boot to wear but find that if I walk carefully with my ankle wrapped in an ace bandage, I don`t feel pain. Is it ok to walk without the boot until I see an ankle specialist as long as I don`t feel pain? Would it be possible to ride a spinning bike to get exercise without doing any further damage? I`d like to know what the MRI results mean. Do the results show that I definitely will need surgery?

Answer:

If you were told by your orthopedic physician to wear the boot, then you should wear it at all times, even if you are not having pain. I would not do any spinning or other activity unless your physician specifically told you that you could.
 
Since your appointment with the specialist is not until November, you can call your physician back and request an appointment prior to this to go over the MRI.

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Response by:

Kendra L McCamey, MD Kendra L McCamey, MD
Clinical Assistant Professor of Family Medicine and Primary Care Sports Medicine
Associate Director, Primary Care Sports Medicine Fellowship
Team Physician, Ohio State University Athletic Department
College of Medicine
The Ohio State University