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Arthritis and Rheumatism

MRI Report and Foot Injury

04/17/2009

Question:

I am interested in the following: my daughter at age 14 severed two ligiments in her right foot on a trampoline. She went through therapy and seemed okay (April 08). Since August 08 she`s started having trouble and now has problems pain and swelling. The MRI impression states patchy areas of the increased T2 and decreased T1 signal within the talus and calcaneus and portions of the cuboid near cuboid calcaneal joint. The appearence is consistent with bone marrow edema which could be related to contusion, more usual forms of edema in the pattern would include reflex sympathetic dystrophy. The appearence is not typical of bone inarction.

Would this be typical of her injury and what is the usual treatment? Is this going to be a life time of pain and problems for her? Thank you.

Answer:

Trauma is the most common cause of Reflex Sympathetic Dystrophy or Complex Regional Pain Syndrome and it is more common in women. Treatments can include medications, physical therapy and other local treatments. Early treatment is strongly suggested. If the final diagnosis is reflex sympathetic dystrophy it should be aggressively treated as early as possible. With early treatment outcomes are generally better however delays in care can result in longer lasting problems.

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Response by:

Jeffrey M Robbins, DPM Jeffrey M Robbins, DPM
Clinical Assistant Professor of Surgery
School of Medicine
Case Western Reserve University