MRI, ultrasound and xray clear, but still major pain in ankle

[sheriffjonny]

Hi,11 months ago i fell from a fence and landed on a rock which pierced my boot and went about 2 thirds of the way into my foot just below my toes. As you can probably realise i struck my foot at the front and the back of my foot overstretched. There were complications with the puncture wound so the hospital didn't really look at my ankle. I had infection in the puncture wound for 4-5 months and couldn't put any weight on it so i was on crutches. After this healed i started to weight bear, but quicly realised that my ankle couldn't handle it very well, it felt as if my achillies was ripped, but after an ultrasound, mri and xrays on it, it was shown to be well and also the tendons around my ankle were in perfect condition.
I'm not using crutches, haven't been since January, and have been having ankle class at physio and been wearing an orthotic insole. The problem is i'm still in massive pain around the areas of my achillies and mainly the right hand side of my ankle. The hospital just can't seem to figure it out, sometime i feel as if i must be imagining it, and then my ankle gives out and i'm on the floor, that tells me i'm not.

Can anybody please offer some insight, this is really starting to affect my life now.

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[Dr Damien]

dear sherrifjonny

you didnt say whether the insoles are helping? if the hospital cannot figure it out, it is unlikely that we would be able to do that on here, since they have had the chance to physically assess you...

having said that, your description sounds like you have instability issues...
how is the range of motion in both ankles compare? any tenderness anywhere, swelling?have you tried an ankle brace ? overstrectched ligaments maybe contributing...

[theshoulderguy]

Hi Sheriffjonny, just thought that I would put my 2 cents in here. Shoulders are my bag but work also in an Ortho clinic.

I would be double checking that there was no separation (widening) of the syndesmosis due to a high impact loading causing ongoing instability of the ankle mortise now when weight bearing. The widening doesn't always show up on Xray unless examined under external rotation and abduction loading. If it does widen under weight bearing then you will be prone to twisting your ankle.

All the best.

Luke

The Shoulder Guy

[Kristiano]

Infection may lead to arthritis. non weight bearing of ankles may lead to stiffness of the many joints in the ankle... pictures of ankle full ROMs and site of puncture will help...