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Swelling and pain on ankle after a sprain. X-ray showed no fracture. Should I have an MRI?

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First, i'd like to share we're overseas. I sprained my ankle 10 days ago while in Cambodia, and have now returned to China where we lie , though we are from XXXXXXX Going to see knowledgable specialist that i can communicate with it going to be difficult, but not impossible, just hard. therefore to simply answer and say i should go see a specialist is not that easy. conditions and treatment here are subpar.
My main question right now is should I have an MRI or not, and if it would help or not.
Let me explain a litte of the background of the sprain. did not see a step and ankle rolled in - stretching/tearing front and outer ligaments. felt tear/stretching across front and side. It had IMMEDIATE swelling on the front and right of the ankle within seconds and lots of pain-like a ball (i can send you a pic) : ) couldn't walk on it of course. Should i add that i could not move the ankle or foot at all. people's faces were fun to watch! The following day i was able to put mild pressure on it a for couple steps on the heal with the foot out in front of me, but not directly over it (does that make sense). it did not seem excrutiating. i noticed mild instability, but not complete. Likely a grade 2 sprain. (i've had other ankle injuries so i knew the difference.) since we were traveling i was unable to keep it elevated, though i did stay off of it. On day four as the pain near the bone was more distinct and i couldn't bear weight on the foot we went for an x-ray - no fracture. Foot has VERY swollen many days. we were in a poor town and all igot was an x-ray and anti-inflamatory med, but no exam of the ankle itself. we were able to locate crutches so i'm dong everything i can to take care of it including wrapping.

On around Day 5 the ankle began throbbing an hurting as badly as i expected it to on Day 2. pain meds help some.

Day 8 -10 the swelling has gone down when sleeping, and i'm home and able to rest o it is not swelling too too much. of course the foot swells up if i'm standing. However the one area on the outside near the bone is still extremely painful. i mean the whole ankle is stll sore and ii'm still not walking on it. THere is also an obvious redish oval right across the area of the ligament. it is VERY SORE - throbs, sore to touch, sensitive, hurts with or with out pressure.

the redness and soreness lies across where i think is the ATFL tibiofibular.

Oh i also need to add this is my 5th ankle infury on this ankle, that is also why i'm concerned
previous grade 2 sprain, previous grade 3 sprain with a 6-week cast, previous stress fracture casted 6 weeks, and a mild sprain about 2 years ago.

also because of that i'm pretty sure it's not as bad as when i had the grade 3 sprain.

So is this just part of the healing? do you suggest an MRI? would it be helpful at this point? i;m not even sure here how well the guys can read it.
should i wait longer for more signs of healing and how long and for what signs?

the healing and long term effects is very importany because i need to return to work and will be on my feet.

Thanks so much. SIncerely,
Posted Fri, 8 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Samik Basu 2 hours later
Hi ,
Thank you for your query.
You seem to be in a very difficult situation.
I should say you should be a little serious about your injury.X rays of those region can be decieving sometimes.
Pain and tenderness persisting for so many days is confusing.
I must say you should have remained in complete rest for a few days.
Stress over the area as well as gravity is increasing the local oedema and tenderness.
I would first advice you three things.
Take complete rest for a few days. Keep your leg in an elevated position.Apply ice packs to the local area.
Continue painkillers.
Healing is not taking place.MRI would be helpful.
You can wait for a day or two.Healing should definitely decrease the pain and swelling and increase your mobility.
MRI in these conditions will help you to exclude major damages in that area.It will also help to diagnose muscle,tendon or cartilage injuries.
Try these measures.If they do not help please consult an orthopedic.
If you have any further queries you are free to consult me.
Hope this answers your query.
Wishing you a speedy recovery.
Have a nice day.
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