Seeking a Second Opinion on Ankle MRI Results
I’m doing my utmost to research my concerns online, but I’m struggling to determine which findings are genuinely alarming and which may merely stem from my active lifestyle as an athlete. As a dedicated rock climber and mountaineer who enjoys long-distance hikes nearly every weekend, I decided to have an MRI after experiencing pain in my ankle accompanied by a noticeable lump. Although the podiatrist reassured me by saying there is a tear but that it’s not serious, I am keen on obtaining a second perspective. Here are the MRI findings: **MRI RESULTS:** - The anterior inferior and posterior inferior tibiofibular ligaments remain intact. - Anterior talofibular, posterior talofibular, and calcaneofibular ligaments are also intact. - Both the deltoid and spring ligaments show no abnormalities. - There’s some attenuation and irregular shape of the peroneus brevis tendon in and just moving away from the retromalleolar groove, which raises suspicion of a partial-thickness longitudinal split tear. Additionally, there is mild peroneal tenosynovitis. - The peroneus longus tendon is intact. - Mild tenosynovitis is noted in the distal posterior tibial area, along with slight fluid in the flexor digitorum and flexor hallucis tendons. - Extensor tendons are intact. - Mild peritendinitis is observed in the Achilles tendon with a trace amount of fluid in the retrocalcaneal bursa. - The plantar fascia is intact. - A ganglion cyst measuring approximately 1.8 x 2.3 cm is located on the lateral side of the ankle, which aligns with the lump I noticed. This cyst likely originates from the sinus tarsi, which appears normal otherwise. - The os trigonum shows partial fragmentation and slight cystic changes in the posterior talus, usually associated with posterior ankle impingement, along with mild fluid accumulation in the posterior tibiotalar joint. - There are no signs of osteochondral lesions, and the tarsal tunnel appears normal. **SUMMARY OF FINDINGS:** 1. The ganglion cyst located laterally on the ankle measures approximately 1.8 x 2.3 cm, correlating with the detectable abnormality. 2. The inferred abnormality of the peroneus brevis tendon raises the possibility of a partial-thickness longitudinal split tear along with mild peroneal tenosynovitis. 3. Mild tenosynovitis is present in the posterior tibial area. 4. There is mild peritendinitis in the Achilles tendon. 5. Observations include partial fragmentation of the os trigonum and mild reactive changes seen in the posterior talus as associated with signs of posterior ankle impingement. I hope to clarify the significance of these results and the best course of action moving forward, hence my search for a second opinion.
Answers (1)
7/9/2025, 10:30:56 PM
OpenHealth AI
It's understandable to seek clarity on your MRI results, especially as an active athlete. Your findings indicate some notable issues, primarily regarding the peroneus brevis tendon and a ganglion cyst, but also some other mild conditions. Let's break this down and discuss actionable steps.
Key Points:
- Peroneus Brevis Tendon: You have a suspicion of a partial-thickness longitudinal split tear and mild peroneal tenosynovitis.
- Ganglion Cyst: The cyst you mentioned is present and correlates with the lump you noticed.
- Other Mild Findings: There are recurring mild issues in the posterior tibial area, as well as mild peritendinitis in the Achilles tendon and observations related to posterior ankle impingement.
Explanation:
- Partial Tear and Tenosynovitis: A partial tear of the peroneus brevis tendon can cause pain and instability, which might impact your climbing and hiking. The associated tenosynovitis indicates inflammation in the sheath surrounding the tendon.
- Ganglion Cyst: This is a fluid-filled sac that can arise post-injury or from repetitive motions, and it's good that it has been identified, as it can sometimes cause pain or discomfort.
- Mild Tenosynovitis and Peritendinitis: These findings suggest some inflammation around the tendons, which can be common due to high physical activity.
Next Steps:
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Symptom Management:
- Rest: Give your ankle a break, especially from activities that aggravate the symptoms.
- Ice Therapy: Use ice packs on the affected area for 15-20 minutes, several times a day, to reduce swelling and pain.
- Compression and Elevation: Consider using a compression bandage and elevating your ankle when resting to minimize swelling.
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Monitoring Symptoms:
- Keep a daily log of your pain levels and any increases in swelling or other symptoms. This can help track changes over time.
-
Physical Therapy:
- A physical therapist can help strengthen the surrounding muscles and improve flexibility, which may alleviate some discomfort and support recovery.
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Consider Further Evaluation:
- Since you seek a second opinion, I recommend consulting another orthopedic specialist who focuses on sports medicine. They can provide targeted insights and may suggest options like corticosteroid injections for inflammation, further imaging if necessary, or in some cases, surgical options to address the cyst or the tendon tear.
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Activity Modification:
- Gradually reintroduce your physical activities. If certain movements exacerbate your symptoms, consider substituting them with low-impact alternatives until you feel more stable.
Conclusion:
While you do have some concerning findings, many of them are manageable with time and appropriate care. Prioritize rest and seek further evaluation for a tailored treatment plan, particularly as an active individual. Feel free to reach out with more questions or updates on your situation.
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