Technology First – Ligament damage – MRI & Ultrasound

Most sprained ankles get better regardless of their treatment, as long as the ligaments holding the joint together are largely intact, or do they? after a bad sprain do ‘the niggles’ go completely, or is there always a ‘weakness’? It’s rarely life-threatening, so how much does it matter as long as the person is not an elite athlete and can still get to work.

Although the ankle joint is usually described as a hinge joint, nothing in the human body is quite that simple! The ligaments around the ankle form a complex joint, allowing a joint that is primarily a hinge joint to have some rotation as well as expansion and contraction to give a close and stable fit between the bones of the lower leg and the bones of the back of the foot

The Ankle Ligaments

MRI of the ankle


It goes without saying that feet and ankles are important. If one joint in the leg is disrupted, the other joints have to compensate and this impacts on their function. Usually, people can get away with one bad joint, providing they are not ‘heavy users’, that is they stick to doing ordinary things, like not running, not playing sports, and definitely not playing football.

Thus consequences of an injured ankle can result in an imbalance in the legs, postural problems, joint problems, arthritis and eventually joint replacement. En route, lack of exercise can lead to diabetes, high blood pressure, obesity and other diseases of modern life.

The correct diagnosis, followed by appropriate treatment,  saves all of the above.

If the person/patient in the previous post had had an MRI when he first injured his ankle, followed by an immediate ligament repair, he could have saved himself a lifetime of ill health. We need excellent treatment, not overtreatment from the time of injury. Expectations need to rise, we need to stop accepting a second rate service because it comes from our beloved NHS.

I don’t believe a money-driven service is better than one driven by targets and performance indicators. Both stop people doing the job they want to do. The old NHS worked because the doctors and nurses believed in putting the patient first, regardless of the hours they worked. Leaving work on time was not in the contract. The European working hours Directive has done Healthcare UK no favours.

“Minor” injuries need first class treatment. Minor injuries accumulate and lead to major damage. Old age may be nothing more than an accumulation of minor traumas – those with fewer injuries and better treatment get less stressed, look younger and last longer. Bad medical treatment is in part responsible for widening Health Gap between rich and poor. The consequences of trivial injuries if not properly treated by a good physiotherapist can last a lifetime.

For Want of a Nail

For want of a nail the shoe was lost.
For want of a shoe the horse was lost.
For want of a horse the rider was lost.
For want of a rider the message was lost.
For want of a message the battle was lost.
For want of a battle the kingdom was lost.
And all for the want of a horseshoe nail.

which is a German proverb, the English is version:

To spoil the ship for a hap’orth of tar
To have something important fail, for the want of a small amount of money or effort

In other words, however trivial the injury might seem and a sprained ankle does not sound like a life changing injury, if not treated properly, it can have serious consequences.

And it is impossible to treat any problem properly without full diagnostic information. That information comes from throwing the highest quality technology we have, at the problem, at the first opportunity.

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