Ankle


Frequently Asked Questions

Is it possible I could have something wrong with my ankle if the X-ray was negative? I was in a motorcyle accident where my foot was smashed hard against the foot pedal. The X-rays looked fine but I don't feel fine. There's a lot of pain where my foot meets my ankle and a lot of swelling there, too.

You may have an injury of the transverse tarsal joint. Sometimes this area is referred to as the Chopart joint. It's where the talus bone meets the navicular bone and the calcaneus (heel) bone meets the cuboid bone. Since the talus sits right on top of the calcaneus, these bones and joints all work together to create a stable but mobile joint. Injury of any of the bones or ligaments holding the bones together in the Chopart joint can affect this transitional zone where the foot meets the ankle. In fact, the most common mechanism of injury for a transverse tarsal joint injury is to have the foot pushed against the brake pedal of a car or against the foot pedal of a motorcycle as you described. X-rays don't always show injuries to this area because its the ligaments that are damaged. When ligaments are torn or ruptured, the joints become unstable. The bones might shift. If the joints reduce (shift back in place) during the X-ray, then it looks normal when developed. It takes careful attention to the mechanism of injury, clinical presentation, and some additional testing to identify injuries of this type. It might be a good idea to see an orthopedic surgeon if you haven't already -- or to head back to the orthopedic specialist for a follow-up exam.

Joseph X. Kou, MD, and Paul T. Fortin, MD. Commonly Missed Peritalar Injuries. In Journal of the American Academy of Orthopaedic Surgeons. December 2009. Vol. 17. No. 2. Pp. 775-786.

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