“Accessory ossicle or old fracture?”
During the summer I twisted my ankle, I had some difficulty walking for a couple of weeks and had mild swelling. I have continued to have issues with it since. The pain is along the outside of my foot. It was doing relatively well other than pain with gentle pressure on the bone or accidentally twisting it on uneven ground. About 3 weeks ago, I had a sharp pain while walking and my foot was swollen along the outside and walking was almost unbearable for 2 weeks. The swelling and redness is still there but is much better. The X-ray impression findings are consistent with an accessory ossicle or less likely, an old fracture with nonunion. Does this seem like an accessory ossicle?
Female | 33 years old
Complaint duration: 5 months
9 Answers
Most likely the former
This looks like accessory ossicle. You probably sprained the ligament connection to it. You probably would best be helped with 4 to 6 weeks of immobilization. Possible surgery if symptoms keep recurring.
Based on your description of the events and the way this particular bone looks on x-rays I feel that this is on old fracture non-union, however this does not look like it is from this summer. Looks a lot older.
An old fracture is more likely but either diagnosis is plausible. I would recommend treatment to be excision of the fragment.
It looks like an accessory ossicle. I think that you partially tear a small attachment of the tendon. It will heal up by itself.
Looks like an old fracture.
This appears to be an accessory ossicle. If the pain and swelling is in the same location then you probably injured the ligamentous connection between the small bone and the larger bone. The usual treatment is wearing a walking boot for 6 weeks and analgesic or anti-inflammatory medication. Physical therapy can be helpful. If it becomes chronic that is no improvement after 3 months of conservative treatments, surgical excision can be considered but before that you should obtain a CAT scan as well as an MRI of the foot.
X-ray finding is consistent with accessory ossicle given its smooth borders.
DK
DK
Yes, but it's impossible to know for sure. The real question is: Is this the cause of my continued/recurrent pain? It may or may not be. I would recommend seeing a fellowship trained orthopedic foot surgeon who can tell you the answer. He/she will probably try to treat you non-surgically at first. However, if the pain continues despite nonsurgical treatment, excision of the ossicle may be required.
Hope it helps!!
Dr. Bose
Hope it helps!!
Dr. Bose
