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Ankle pain, x-ray suggests osteochondritis dissecans. Done Dorsi-flexon test. Should I seek further advice?

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Orthopaedic Surgeon
Practicing since : 1994
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Hi im 23 years old and in 2008 i had a Osteochondral lession in the Talus of my Right ankle and had it operated on with fragments removed. In 2010 i had a Stress Fracture of my 1st Metatasal (same ankle). From then i havent had any problems until about 7 weeks ago i rolled the same ankle. Had an xray and the report said 'there is a small area of cortical irreguarity medial at the dome of the talus suggestive o osteochondritis dissecans. (not sure if this is just showing up because of the surgery i had previously) the physiotherapist sent me on my way not doing anything. Over the past 7 weeks i have had chronic pain in the ankle after any walking or exercise to the point wear i cannot weight bear, so i thought i should seek another physiotherapist, i saw him last week and he said i have a very weak and unstable ankle, He did a weight bearing Dorsi-flexion test where i stand up facing a wall with a ruler at my feet and seen how many centimeters it was before my knee would not touch the wall and compared it with my good ankle and there was 7cm difference. Should i be seeking any further advice or go back to the physiotherapist?? As i am an active person i would really like to excerise soon. Any advice would be great. Thanks.
Posted Mon, 3 Sep 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 1 hour later
Thanks for posting your query.
Your symptoms and instability of the ankle joint are due to osteochondritis dessicans of the talus.
It can happen after an injury to the talus and involves bone and its adjacent cartilage necrosis due to loss of its blood supply. This is followed by degeneration and inflammation of the area.
You need to consult an orthopedician who after a clinical assessment will guide you regarding the conservative or surgical treatment options.
Meanwhile avoid weight bearing on the foot at all costs. Do not indulge in any heavy exercises involving the foot as it may cause pathological fractures in the area. Rest and mild like acetaminophen are recommended till then .
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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