If you have symptoms of an ankle sprain and the symptoms have not improved over time, your doctor may order an MRI for further examination.
In these cases, an MRI came back normal, If you have ankle sprain symptoms and the symptoms have not improved over time, your doctor may order an MRI for further examination.
In these cases it is possible:
MRI came back normal but still in ankle pain
So what is the cause?
After your ankle is twisted, a crunching or cracking sound is heard and severe swelling occurs. Pain and bruising are also symptoms of a ruptured ankle ligament that can spread to the toes.
One of the most important points when examining an ankle that has developed the above symptoms during ankle rotation is to rule out possible bone fracture or cartilage damage following ankle sprain. MRI cannot differentiate between soft tissue injuries and fractures and cartilage damage, Therefore, despite the ankle pain, the MRI may be normal and there may be no injury or rupture of the ankle ligaments except a slight swelling of the soft tissue.
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Briefly about the anatomy of the ankle
The ankle is made up of four following bones:
The fibula and tibia are located at the top and the talus at the bottom, and the calcaneus is located below the talus.
Between the contact surfaces of the bones, there is some cartilaginous soft tissue. In the human ankle, there are strong bands called ligaments that attach to the bones and prevent the bones from moving apart. In other words, the ankle ligaments hold the ankle bones together.
Tendons are also strong tissues that attach muscle to bone. The largest tendon in the human body is the Achilles tendon, which is located behind the ankle.
Types of ankle injuries
When your ankle twists, both soft tissues and bone tissue and cartilage tissue may be damaged.
The symptoms of an ankle fracture can be quite similar to a twisted ankle and sprain.
In an ankle injury following a simple sprain and swelling, pain and bruising, it is important to check for the possibility of bone fractures or cartilage damage.
In severe cases of fractures, the person cannot put their weight on the ankle, but in other cases, the symptoms are the same as heel sprains and soft tissue injuries (ligaments).
So what is the cause?
After your ankle is sprained and twisted, a crunching or cracking sound is heard and severe swelling occurs. Pain and bruising are also symptoms of a ruptured ankle ligament that can spread to the toes.
One of the most important points when examining an ankle that has developed the above symptoms during ankle rotation is to rule out possible bone fracture or cartilage damage following ankle sprain. MRI cannot distinguish between soft tissue injuries and fractures and cartilage damage, Therefore, despite the ankle pain, the MRI may be normal and there may be no injury or rupture of the ankle ligaments except a slight swelling of the soft tissue.
The most important diagnostic tool for fractures and hard tissue injuries is a simple x-ray. Sometimes a CT scan may be used to make a more accurate diagnosis.
X-rays can show damage to bone and cartilage tissue.
If the pain in a twisted ankle does not improve within four to six weeks, the doctor will sometimes ask for an MRI to look more closely at soft tissue injuries, such as ligaments.
So we see that if there is a fracture of the bones or damage to the cartilage of the ankle, the MRI can be normal because the MRI cannot show the details of the hard tissue damage. This is when ankle MRI is normal but the ankle pain still persists.
Hard ankle tissue injuries are the cause of this discrepancy.
Hard ankle tissue injuries
Hard ankle tissue injuries include:
- Ankle fractures
- Internal ankle fracture in the ankle area
- External ankle fracture in the ankle area
- Ankle fracture in the ankle area
- Fractures of two ankles in the ankle
- Fractures of the three ankles in the ankle
- Pilon fracture or ankle fracture
- Fracture of the talus bone in the ankle