Help to understand MRI report

Foot care
1

Hi,

I’m hoping someone will be able to help me understand my daughter’s MRI report…

Brief (ish!) background is she injured her ankle/foot about 2 yrs ago playing football. We were told by minor injuries clinic that no break but to book physio via GP (I can’t remember why, but there was something on the x-ray that made them suggest this). Following months of no PE and just physio she was told she could go back to normal activities about a year ago. But, as soon as normal activities resumed, she was in pain again. GP referred back to physio but, this time, physio said maybe some other investigations might be needed. GP referred to orthopaedics and they sent her for MRI. However, when we went back to get the MRI results a few weeks ago, it was a locum doctor and he was really short with us and all he would say was that he was ‘unconvinced’ by the MRI and she should take another 6 months off PE and then maybe they would repeat the MRI then. She has now been unable to take part in activities normally for around 2 years, and was previously really sporty. She is also really miserable as, even after all this time, even walking is painful. Our GP gave us a copy of the MRI report itself, while we are waiting to go back to orthopaedics again. It doesn’t mean anything to me (other than I know what bone the tibia is!) so if anyone can explain it or advise any self-help we can do I would be really grateful.

MRI report states: There is an ill-defined hyperintensity (PD fat sat) noted in the anterior part of the distal tibial epiphysis (image coronal sagittal 13 but best seen in axial PD fat sat 7). It measures about 15 x 8 x 5 mm. On sagittal T1 and coronal PD images it is seen as a low intensity line. No apparent fluid cleft can be seen deep to it. It most likely is an osteochondral injury. Not other osteochondral abnormality in the ankle, subtalar or other intertarsal and tarsometatarsal joints. All ligaments in the ankle particularly lateral and medial collateral ligament complex appear normal. No soft tissue abnormality noted. All tendons appear normal intact. Conclusion: Appearances in keeping with an osteochondral defect, likely to be stable, in the anterior median tibial epiphysis.

Thank you so, so much for any help you can give!

2

Sorry - conclusion should have read: in the anterior median distal tibial epiphysis

Thanks!

3

Hi there Abraham. I’m in a little bit of a hurry so I’ll do my best to boil this down in english. But I saw your post and unfortunately I’m pretty certain I understand what the MRI report is stating. When I was a 16 year old sophomore in high school I was also diagnosed with the same thing. Only difference in my situation is that I had no prior trauma to my ankle, it was just that I had “repetitive trauma” to the joint over many years. (Basically I was a young boy that loved to play soccer). The epiphysis is the rounded ends of the long bones in our bodies. Those tiny areas are very complex with a lot of soft tissue. In youth our growth plates between bones are particularly vulnerable to osteochondral defects, lesions, etc. due to how rapidly our bodies are growing. Add to that an active child with a prior injury. So I wouldn’t say that it’s super common, but it is certainly not unheard of.

Believe me, I know how painful it is for her in addition to the frustration of not having any credible or satisfactory answers or explanations. The long and short of it is that she will most likely need to really take it easy over the next 6-12 months. It will probably be on the longer end of that given that is very much of a weight bearing joint. As a 16 year old runner and soccer player, that news was the death sentence to me. Continuous activity on the joint for this injury is exactly what you do not want. I tried for weeks to push through it but the excruciating pain ultimately forced me to yield and rest it

It will self resolve over time. :blush: Mine did after 7 or 8 months and it’s never been an issue since.

Patience and rest is the goal here. Good luck to you guys. :+1:t2:

John