Question: I had this MRI done about a year or so ago. What does it mean? My ankle keeps locking up to this day and nothing has been done about it. Should I be worried or keep falling down everytime I can't move my ankle and the pain is horrifying. My orthopaedic dr gave me an Nsaid called meloxicame of something like that. I have factor 2 disorder and am on warfarin and cannot take that. I'm just frustrated and fed up with none of my doctors answering my questions or helping me. Thank You in advance for your help. The following is the results
IMPRESSION:
1. Small posterior subtalar joint effusion.
2. Negative for quinolone induced tendinopathy.
3. Mild edema within the anterior aspect of the sinus Tarsi extending to
the lateral aspect of the talonavicular joint. This is a nonspecific
finding.

Dear Dr. Aashish XXXXXXX

Thank You for getting back to me. I would like to apologize in advance for this next letter or email because it will be very long. I am trying to get all the facts to you and come up with a long term solution for my problem. I appreciate your help with this matter and for you giving me another orthopaedic Surgeons opinion.

I never got any information from my doctor about my ligaments when I asked my doctor’s nurse. It was my primary care doctor who ordered the MRI initially. When he got the results back he told me I had to go see a specialist. The first specialist he sent me to was awful walked in the room told me to take off the boot and leave and he wasn’t going to help me at all because he had other patients more worth his time. That it would go away over time anyways. I left crying. Then it took me months to find another ortho doctor that took my works insurance.

I have not sprained my ankle since all these problems started that I am aware of. I have sprained many ankles as a child and wrists and everything else, what child in competitive sports doesn’t?

When I had my daughter exactly 2 years ago yesterday somehow there was retained placenta left inside of me. It came out 3 months later as I gave birth to it. My doctor told me that to be safe he was going to place me on Levaquin and another antibiotic which I cannot remember the name of it. I just remember it making my mouth taste like metal. While I was taking these antibiotics I pretty much turned into what I call an 80 or so year old lady. My entire body hurt, I could barely move all my joints and bones started to lock up. I figured it was just a normal side effect and that I would be done with them soon enough. I was at work one day when I collapsed and the head pharmacist came rushing over. He helped me up as I cried in pain and told him I needed to go home. He asked what was going on and I explained that I was placed on these antibiotics because of the retained placenta. He immediately told me that I was having an allergic reaction to the Levaquin and that he would call my doctor while he sent an ambulance to take me to the hospital. He said I should have said something way before then, well I did not know and no one warned me. I could not even open up a bottle of soda or pick anything up with my hands without a huge struggle and pain.

It was during all this time that my left ankle started locking up and I would have to pull on the bottom of my foot and wiggle it a bit until it would pop back into place. It is one of the most painful things I have been through. I still get pain in my knees, spine, hands, joints, and fingers. However, it is nothing like my ankle or foot I should say because it is like my ankle locks and I cannot put any weight on either my ankle or foot and I cannot move either of them. It is completely locked and sometimes I cannot get it to unlock. This is what made my primary doctor order the MRI. If you notice in the impression of the MRI, number 2 states “negative for quinolone induced tendinopathy”. I was told by this new ortho doctor how that was the statement that proves this is not from the Levaquin. Right after saying this to me, he told his nurse to put in the system that I am allergic to Levaquin. When the nurse asked for the symptoms I get if I take it he stated “arthralgia”. I hope I spelt that right. Now I am not a doctor but I know arth-o means something to the extent of arthritis or bone problems. This was literally immediately after telling me it was not from the antibiotic. I said wait so what is it from then? He said he did not know but would take X-Rays right away. He did and those results came back as follows:

XR ANKLE LEFT AP LATERAL AND OBLIQUE – Details

IMPRESSION:
No evidence for fracture or dislocation of the ankle.

Component Results
There is no component information for this result.

He told me the results and I am still unsure why a non-broken ankle or no dislocation of the ankle has anything to do with the symptoms and what is going on? He told me to do the physical therapy, take the meds, wear the heal wedge, get the special insoles for my shoes and it will go away in no time. Well it hasn’t.

My venous thrombosis came after all of this in which I found out I had factor 2 disorder and was placed on Warfarin. So up until that point I was also taking my meloxicam. I go to physical therapy 3 times a week for both my ankle and my neck and I also work on exercises at home that they give me to do. Every night I spend an hour placing my foot and ankle in a bucket of ice cold water for 10 minutes then place it a bucket of very hot water to help with the pain and circulation. I continue to go back and forth every ten minutes for an hour or as long as I can do it. It helps take the edge off a little bit. I am under strict orders from my cardiologist not to take Tylenol unless absolutely necessary and only 500 mg at a time because my INR is not yet stable and within proper range. My ortho doctor who I am very upset with right now told me not to wear my brace anymore because it would weaken my ankle more than it already could possibly be from being in a big black immobilizer boot for months. I asked if I could slowly wean myself off of the brace because it really did help during the day while I worked. He agreed.

You stated in your response to me from my first questions to you that I can get or possibly should get a steroid injection into my ankle joint which is supposed to provide some pain relief and inflammation subsidence. I recently had an occipital block done which was supposed to cure my massive migraines, only it made them way worse and had the opposite effect. Will these steroid shots be the same thing? Will I have to continue getting them for life? Is there a more long term approach that would help? I just can’t take this pain anymore. It is destroying me.

I should be able to celebrate and enjoy my life when it is a miracle I am alive after having a severe venous thrombosis and almost dying. I want to be able to carry my daughter again, and play with all my children. It is the saddest thing in the world knowing you can no longer do for your family or children what you used to be able to do. I have been fighting with every ounce of my being to make it through every medical battle thrown my way unexpectedly and I keep coming up short because my doctors won’t listen to me. I work in healthcare, I always believe in listening to my patients and giving them time, respect and listening to their needs, not rushing them out like they don’t matter. I feel like no one either cares about helping me or believes me or they just don’t know what to do to help. Maybe they have never seen this before I do not know, but I am begging for some good advice. And if you know any good Orthopaedic doctors in or around the XXXXXXX WI area that can help please let me know.

Again, I am sorry for the enormous letter of information and questions I have sent your way. I just want help at this point. Thank you so much for your time, patience and help so far.

Sincerely,

Jamie

Thank You so much for the help you have given me and for the awesome referall. You were very prompt with your responses and did an amazing job. I finally feel I have hope that my ankle will get fixed. I hope I can come to you with future questions because you are very knowledgeable and considerate.

Sincerely,

Jamie