Ankles: Sprains and Pains

For any building to be upright, it requires a solid foundation. Such is true for the human body: if what’s below the knees goes wonky it can have an effect on the body as a whole. Ankles are incredibly resilient joints but when they take a hit (or a fall or a twist) they can be problematic.  

Ankle sprains are common, and can be seen in athletes and nonathletes alike. Sprains can result from the ankle turning from a misstep, from stepping down at an angle or from sideways movements. There are clinical rules which help determine who needs imaging- mild sprains may not need to be imaged.  

Sprains typically result in injury to the ligaments, those soft tissue bands which connect bone to bone. If the ankle is unstable or if symptoms do not improve as expected, imaging with an MRI may be needed. This allows assessment of the bones of the ankle as well as the soft tissues, including the ligaments.  

A fall from a height may lead to fracture or dislocation (ouch). Plain films of your ankle will be the starting point if fracture is suspected.  If a fracture is complex, CT is excellent at showing the anatomy and helping your surgeon plan treatment.  

Achilles tendontears are often an event with a distinct injury, sometimes related to a sudden movement and abrupt tensing of the calf muscle (Remember those replays of Lebron James’ injury? Ouch!). Physical exam will often reveal a focal defect in the tendon your doctor can feel. We may want to image to see if the tendon is completely torn and the distance between the torn ends to help with surgical planning. Ultrasound can show this nicely, as can MRI.  

Tendons about the ankle other than the Achilles can also be injured, torn or inflamed. Injuries to other ankle tendons can also be evaluated with ultrasound, although MRI is more commonly used. Tendons about the ankle include the peroneal tendons on the outer side of the ankle and the posterior tibial tendon on the inside.  

It’s important to treat ankle injuries, because as a foundation for the body, adding a limp can lead to other problems including back pain (double ugh). If left untreated, ankle sprains can lead to chronic instability.   As ever, prevention is the best medicine. Some ankle strengthening exercises can be found here.

Image credit: Broken ankle Cast detail by FiDalwood via Wikimedia Commons Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)

Originally published 4/24/14 on diagnosticimagingcenterskc.com.