Wednesday, April 24, 2013

and the results are in!

4 weeks later and I finally know what is going on in my ankle!  I'll spare you the details of what scheduling was like...but I ended up getting in at 7am.  Good thing I'm an early riser (not by choice- but for work).

So here is what the MRI report says: (my comments in pink)

There is signal abnormality within the distal fibula which is non specific possibly related to bone contusion.  Additional marrow signal alteration is also seen however with the medial malleolus (inside ankle bone) as well as the as the more inferior portions of the talus.  Little if any calcaneal signal alteration noted.  Freaked out about this- but Dr says it's pretty normal and it doesn't match my symptoms- although I'd say I have pain in by medial malleolus when I stretch my calf.  Whether these areas relate to additional areas of contusion etc. is difficult to determine.  There is fluid with the ankle joint.  Soft tissue swelling is noted medially and laterally. Yep.  The anterior talofibular ligament is not well defined on this examination compared to prior study and may have partially torn. That would be the goose egg next to anklebone  Exclusion of injury of deeper fibers of the deltoid ligament is difficult.  Had to google this one- once again that inside medial malleolus pain... hum.  Ligamentous structures about the ankle appear to be maintained.  That's good, since it was my calcaneofibular ligament that detached and must have reattach sans problems.There is some non specific enhancement with the bilateral soft tissues which should be clinically correlated particularly if there are any symptoms referable to an infectious/inflammatory process. WTF?  No soft abscess seen.  So, what is that hard lump in front of my ankle? 

Can you find the superior extensor retinaculum?  That's the lump.
Of course, google was not my friend since the MRI report was vague and I knew my Dr would probably tell me it was nothing...and it kind of was. 

He told me that the signal alteration in my marrow is pretty normal to see in a MRI, swelling, yep, and the lump was a thickening of my extensor retinaculum but my tendon in front was fine.  He did find a bone spur that the MRI report didn't include which seems to be my problem.  It is pretty small but as soon as he put his thumb on it- yikes it hurt.  It's right at the distal (bottom) of my tibia next to the medial malleolus.  He told me that we could try an injection or arthroscopic surgery if it hurt too bad.  I heard surgery and started shaking my head.  He said that if/when it was killing me then we could revisit that option later.  He also mentioned that I have mild arthritis (NO! I'm NOT that OLD!). 

So...all this MRI drama and I have nothing really resolved other than knowing what it is.  I'm cleared to run "as tolerated". (I didn't think I had to ask!) And so I did.  6.2 miles right after and 2.62 later that night for Boston. (I don't think I can express my sadness in the whole Boston Marathon attack- too awful so I'm going to spare you). 
Running buddies, photo by Cub


Around 2,000 runners running 11 laps at the local track for the victims of the Boston Attack

Obligatory Ankle picture (not too swollen from that angle) 14 weeks post injury
I'm going ahead and running the Flying Pig in 2 little weeks from now.    I can do a 10k and a 5k, so now, will I be able run/walk the half?  I'm going to try.  But one race at a time seems to be the best way of looking at it right now. 

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