When patients presents with this complaint a full radiograph of the ankle / foot is required to help.   Surprisingly the pain is usually not in the ankle joint, but rather a very little talked about joint called the subtalar joint.   This joint is below the ankle joint in the foot.  Testing for this is involves moving the foot in and out by grabbing the heel, called an inversion / eversion stress test.   Clinical exam will review pain in the outside of the foot right underneath the small ankle bone, fibula.       Subjective complaints from the patient can be burning, shooting pain and stiffness in the morning with difficulty with uneven surfaces.

 

Case below is a 72 year old RN presents for second opinion on her ankle pain.  She has been to other doctors to no avail. Xray below was taken.

Symptoms: Pain in the lateral foot below the ankle joint. Pain on uneven surfaces, stiffness and pain in the morning.   Manual test shows pain upon inversion and eversion of the isolated joint.  Patient did get immediate relief with 1% lidocaine into the subtalar joint.

Preop Xray below.

FFLC patient preop: note the malalignment on this view.  MRI confirmed swelling  and ligament  injury in the subtalar joint

 

 

AFO

Serving Southwest Florida Since 2005, Family Foot & Leg Center has 9 convenient locations throughout Collier, Lee, Charlotte, and Sarasota Counties. Offering pediatric to geriatric family care: Ingrown Toenails, Heel Pain, Bunions, Foot / Ankle Arthritis Pain, Plantar Fasciitis, Foot / Ankle Surgery, Custom Orthotics, and Diabetic Wound Care. In office X-rays, ultrasounds, and minor surgical suite exam rooms. Practice powered by EMR and advanced technologies. Home of the Lam Minimal Invasive No-Scar Bunion Surgery! Come Discover Why Patients Love Our 5-Star Foot & Ankle Care! Same Day Appointments! Easy Online Appointment Scheduling!