Misdiagnosis of foot and ankle injuries can result in arthritis, says review of the evidence

Healthcare professionals should use additional imaging and second opinions when diagnosing six common foot and ankle injuries, highlights research in the Journal of the American Osteopathic Association.

The work, by a team of orthopaedic surgeons, found that misdiagnosis often results in poor long-term patient outcomes, including arthritis and disability.

The six common injuries that are difficult to definitely identify are: snowboarder’s fracture (lateral talar process fractures); os trigonum injuries; Lisfranc injuries; turf toe; navicular stress fractures; and syndesmotic injuries.

“These types of trauma are a clinically significant source of morbidity and long-term disability among patients,” says lead author, Dr Jessica Reissig. “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.”

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.

Often these injuries can be resolved with medication, immobilisation, ice and rest, although some need surgery.

“Once the diagnosis is confirmed, in many cases patients can be offered a range of treatment options from conservative to surgical,” says Dr Adam Bitterman who is involved in the work. “Choosing the best treatment for the individual can prevent the injury from decreasing the patient’s future quality of life.”

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