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Misdiagnosed foot, ankle injuries may result in arthritis, chronic pain and disability

Date:
January 30, 2017
Source:
American Osteopathic Association
Summary:
Front-line physicians are advised to err on the side of caution and opt for additional imaging and second opinions when diagnosing six common foot and ankle injuries. A new study by orthopedic surgeons finds misdiagnosis often results in poor long-term patient outcomes, including arthritis and disability.
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Front-line physicians are advised to err on the side of caution and opt for additional imaging and second opinions when diagnosing six common foot and ankle injuries. A new study by orthopedic surgeons finds misdiagnosis often results in poor long-term patient outcomes, including arthritis and disability.

Their clinical review, published in the February edition of the Journal of the American Osteopathic Association, outlined subtleties that complicate identification and treatment of snowboarder's fracture (lateral talar process fractures) as well as os trigonum injuries, Lisfranc injuries, turf toe, navicular stress fractures and syndesmotic injuries.

More than 3 million emergency room visits in the United States each year are related to common foot and ankle injuries. The authors encourage clinicians to be suspicious and obtain additional imaging or a second opinion from an orthopedic surgeon to confirm the initial diagnosis.

"These types of trauma are a clinically significant source of morbidity and long-term disability among patients, not just those who are elite athletes. In many cases, the clinical symptoms are vague and tough to detect with standard imaging," said lead author Jessica Reissig, DO, of the Department of Orthopedics at Plainview Hospital in New York. "As an osteopathic physician, I view treatment of foot and ankle injuries as acute and preventative care because a mismanaged injury leads to so many future problems for patients."

Dr. Reissig noted that untreated snowboarder's fractures, Lisfranc injuries and turf toe have a high correlation to future arthritis, as well as the potential for severe pain and disability years after the injury. Improper treatment of other foot and ankle traumas can result in compensation injuries and other issues including tendinitis and recurrent ankle sprains.

While in many cases, these injuries can be resolved with a combination of medication, immobilization, ice and rest, some require surgical intervention. Elite athletes may also opt for surgery in order to resume their sport sooner, said co-author Adam Bitterman, DO, of the Hofstra Northwell School of Medicine.

"Once the diagnosis is confirmed, in many cases patients can be offered a range of treatment options from conservative to surgical. Choosing the best treatment for the individual can prevent the injury from decreasing the patient's future quality of life," Dr. Bitterman explained.


Story Source:

Materials provided by American Osteopathic Association. Note: Content may be edited for style and length.


Journal Reference:

  1. Jessica Reissig, Adam Bitterman, Simon Lee. Common Foot and Ankle Injuries: What Not to Miss and How Best to Manage. The Journal of the American Osteopathic Association, 2017; 117 (2): 98 DOI: 10.7556/jaoa.2017.020

Cite This Page:

American Osteopathic Association. "Misdiagnosed foot, ankle injuries may result in arthritis, chronic pain and disability." ScienceDaily. ScienceDaily, 30 January 2017. <www.sciencedaily.com/releases/2017/01/170130133350.htm>.
American Osteopathic Association. (2017, January 30). Misdiagnosed foot, ankle injuries may result in arthritis, chronic pain and disability. ScienceDaily. Retrieved April 27, 2017 from www.sciencedaily.com/releases/2017/01/170130133350.htm
American Osteopathic Association. "Misdiagnosed foot, ankle injuries may result in arthritis, chronic pain and disability." ScienceDaily. www.sciencedaily.com/releases/2017/01/170130133350.htm (accessed April 27, 2017).