Bone marrow edema talus
March 15, 2011 | 15,00 EUR | answered by Christian Klein
Dear Sir or Madam,
I am requesting your support and your experience report. Attached you will find the diagnosis of my son's ankle. My son twisted his ankle while playing football and tore the LFTA ligament. He also has a capsule injury. After 14 days in a cast, he started rehabilitation training. Then his foot started hurting and an MRI was done. Please see the attached report.
The doctor's therapy: Currently taking Calcionit, Orthomol Sport Calcium 800 mg. Also undergoing daily magnetic field therapy. My son is attending school as usual. It only hurts when making quick movements. He is behaving calmly.
My question is: Will everything heal completely and will he be able to play football again? What tips or experiences can you give me and are we on the right track with the treatment method? What else can be done? Where does this edema come from? What does the diagnosis actually mean in layman's terms? A follow-up MRI is scheduled in 4 weeks. Thank you.
Sincerely.
Good evening,
Your son had a sprain injury of the upper ankle, where the position of the foot and the outwardly acting rotational forces led to the typical pattern of injury. The outer joint capsule and the most commonly affected anterior lateral ligament were injured, and the joint partners in the upper ankle, namely the joint side of the lower leg and the talus, collided due to the impact. Fortunately, this did not result in a fracture, but rather in a bone marrow edema or "bone bruise", which can be imagined as a bruise in the affected cartilage / bone portion. In the MRI, this region can be seen as a bright spot in a certain orientation, as there has been a fluid accumulation due to the impact.
Regarding the treatment, it can be said that the measures taken can help shorten the healing time, although there is no definitive proof. A torn LFTA should be treated with a stabilizing bandage for approximately 6 weeks in cases of instability in the drawer test.
However, bone marrow edemas can be very persistent and can cause pain for up to 3 months during certain movements. A follow-up MRI in 4 weeks is advisable to determine if there is regression of the edema. Sometimes, it may still show up in the MRI after 3 months.
Overall, the prognosis is likely to be very good and full sports capability should be achieved in 6-8 or even 8-12 weeks. Rarely, inflammation of the joint lining or minor scarring in the joint due to the bruise can cause residual symptoms, which may require arthroscopy as a last resort.
I recommend continuing with the ongoing treatment and full weight-bearing after 6 weeks based on pain.
Best regards,
Dr. Ch. Klein
