Can someone explain this medical-ese for me? (Foot-related):
“There is an ununited apophysis involving the medial aspect of the tarsoinavicular . . . inflammation at the cartilaginous union between the apophysis and the main body of the navicular”
In other words . . . why does my foot hurt so f**ckin’ bad?!
It could be the inflammation that’s noted, or it could be something else altogether.
What were the instructions given to you? If it was to take something for inflammation and stay off your foot as much as possible, that’s probably the reason your foot hurts.
Can you post the full medicalese, your approximate age, and any clinical symptoms or findings? Is this a plain Xray or MRI or CT study?
Any chance it is an ununited epiphysis, not apophsyis?
I may not be back on the board til Sat AM…
Okay, here we go. This is all from x-ray findings:
“There is not soft tissue swelling. There is no evidence of acute fracture. There is no evidence for dislocaion. There are no radiopaque foregin bodies. There is an ununited apophysis associated with the medial aspect of the tarsal navicular bone bone. The patient indicates that this is the precise site of pain. It is possible that the patient has inflammation associated with the cartilaginous union between the ununited apophysis and the body of the navicular. MRI correlation is suggested for further evaluation. There is a small heel spur.”
*Phew!" I am 40 and my foot is swollen and bruised in the area. I have a deep, throbbing pain in the foot and I haven’t sprained nor dropped anything on it. the pain often creeps up the back of my calf and behind my knee. An ultrasound ruled out blood clot/vein issues.
Love your moniker! I have been taking aspirin and motrin and icing it for three days; the pain got so bad that I ended up at the ER. They want me to continue icing and Motrin and walk with a cane and one of those cast-y shoe things. However, putting weight on my foot doesn’t increase the pain at all; in fact, it seems to hurt most when I’m sitting or lying down.
Could be anything. Heel spurs are often asymptomatic, but that could be the reason for your pain. It could be a ruptured blood vessel; it could be tendonitis (although that wouldn’t explain the bruising); it could be…
So, does the medical-ese basically say that there might be some cartilage that is being pressed and/or stretched between two bones?
Potentially, but a more definitive answer can only be given with an imaging modality that goes beyond plain x-ray or by a practitioner who might know the common causes of inflamation in that specific area. Sorry, I wish I could be more help.
The above answer was given by me, btw. bstenger is my nephew and I thought I was signed on. :smack:
Start by pulling up the xray images 40-42 on the left in this link: http://members.fortunecity.com/radrep/id26.htm
There are two “navicular” bones. One in the wrist (aka the scaphoid) and one in the foot (the “tarsal” navicular). So they are talking about a bone in your foot (duh) call the navicular. Go to an anatomy site to see which bone they are talking about.
Bones start out with a matrix that gets calcified. The feet have lots of individual bones. All of these bones can be associated with “extra” little calcified areas which are essentially developmental variants; places where the underlying matrix has calcified in a pattern which creates a complete accessory bone or just an island of calcified matrix where the underlying matrix (cartilage, for instance) is still an extension of the main bone but the ossification (calcified part) is distinct from the rest of the main bone. (I swear I’m trying hard not to inject more medicalese…)
OK…an apophysis (v an epiphysis…) is just a calcified area connected to the main bone by a non-calcified matrix. Usually calcification centers all connect up as you finish growing and the whole bone is completely filled in with calcium. Sometimes the the calcium centers don’t connect completely and now you have an “ununited apophysis”–a calcified bony center that belongs to the overall bone but is separated by a non-calcified area. See Image 5 in the link for a common apophysis we see all the time, and one that medical students commonly mistake for a fracture because it looks like a chip off the main bone.
Back to your medicalese.
Your xray shows no evidence of pathology–no evidence that something is definitely structurally abnormal. You have a normal variation–an aphophysis of the navicular, on the side of the naviclar bone toward the instep. Because this variation (which has been there since your bones finished growing at the end of puberty) is exactly where you are having symptoms and signs, the question is whether or not there is pathology (such as an inflammation in the the cartilage between your navicular apophysis and the main navicular bone) that is not being seen on the xray, but is related to the apophysis in some way. Even normal variations that have been there all your life can develop disease.
Clear as mud?
You need an expert opinion to help decide what to do next. Among the possibilities to help clarify the situation is an MRI, which will show the soft tissues much more clearly than an xray.
FWIW it sounds like what you are calling “swelling and bruising” means that there are clinical findings on the outside of the foot so the question becomes whether or not this is related to a condition from deep inside the foot and the foot bones, or whether it’s related to something near the skin.
Heel spurs rarely cause pain. They are a consequence of chronic inflammation in the plantar fascia, not the origin of the problem!!
Otherwise, what Chief said.
You mentioned some pain in your calf, but is there any swelling and/or bruising behind your knee or on your calf? The reason I ask is that a ruptured Baker’s Cyst can definitely cause swelling and bruising of the FOOT. In other words, although most of your symptoms are arising from the foot, the root cause is that a cyst behind the knee may have ruptured.
Thanks, all, for the explanations. I’m scheduling an MRI and we’ll get to the bottom of this (or the foot, as it is). Whatever it is, it really hurts: a deep, dull, throbbing pain that is making me *very * grouchy!
Mine do. But they’re huge. My podiatrist has me scheduled to get them worked on in a month or so.