MRI Report on childs ankle...any professionals can help me understand it please?

[lionsmane22]

2 months ago, my 12 year old son hurt his ankle skateboarding. It was painful and badly swollen, so we brought him straight to a minor injuries unit. There it was x-rayed, they said it was a bad sprain, and strapped it. He had crutches for 4 days and then started hobbling about on it.

2 weeks later the minor injuiries unit called and said they'd like to see him again for review. It wasn't clear why but he went, another x-ray, told all fine.

Another week later, another call. Told that something may have been missed, could he come for an MRI? Confused, we duly went. Sent to fracture clinic 2 days later.

Consultant didn't have the MRI, told us we had wasted our time and it hadn't been necessary, and made him walk on heels and tiptoes, told us we could go. Made me feel quite stupid, as if I had been the one insisting instead of being called back several times!

Now, I have jus recieved a copy of the MRI in the post, 2 weeks later. The cover let says it is "reassuring in all aspects", however I am far from reassured and more confused than ever....

It says (excerpts):

"Twisted right ankle while skateboarding, XRay in Minor injuries showed FIBULA FRACTURE AND WIDENED MORTISE, MISSED INJURY"

"There is a Salter-Harris Type 2 fracture of the distal fibula. Extensive associated marrow oedema is present. All ligaments are intact. Extensive but patchy oedama within the talus navicular and anterior process and in the ... metatarsals.

Conclusion There is an undisplaced ulnar (typo for fibula?) has type II fracture of the distal fibula in anatomical alignment at the level of the syndesmosis, with associated marrow oedema an periosteal oedema. There is extensive but patchy oedema within...(as above)

Sorry this is so long but can anyone advise on this? Does this mean he had a fracture, it was on the original XRay, it wasn't noticed, or on the second XRay, and it was seen on the MRI but was not mentioned to us?

IS it dangerous to leave this injury unknown to the patient and untreated? Isn't it pretty bad to have a patient have a missed fracture and you don't even tell them?
And should I be doing something now?

Thanks in advance for any advice.

You shouldn’t have to interpret it.
Can you ring the fracture clinic? Tell them you have had the MRI report sent straight to you and it makes no sense given you were discharged
Failing that I would ask your GP to chase it up with orthopaedics.
it sounds like a fracture. But the assessment by orthopaedics also plays a part so hard to interpret a scan in isolation
hope that helps

I called and they said as he had been discharged then he needed no follow up and there was no-one I could talk to. I left a message on the answerphone of the consultants secretary anyway, hoping they will call me back next week.

I'm genuinely amazed that it says the first XRay and the MRI both showed a fracture but nobody thought this worth mentioning to us!

Oh I’ve totally been in this boat. Major ongoing ankle pain for months, x-ray showed nothing, finally got a mri. Saw the consultant who said the mri showed I had an unusual tendon tear but he was going to ask a colleague for a 2nd opinion so could I come back in two weeks.

i asked for a print off of the mri report and sat in the car park reading it and it said my fibula was fractured. I saw my private physio the next day who confirmed the mri report said it was fractured and he sent a snotty email to the hospital asking what they were playing at.

id lost confidence in the hospital so transferred care to a different one who marched me straight down the plaster room and plastered it. Said my fibula was shattered at the bottom. Had been for about 6 months by then, I was in agony. 3 years on I’m still in agony and my ankle is totally fucked. I’ve had one surgery on it and I’m waiting for another but it’s tendon damage rather than bone now I think.

the fibula does only carry 14% of body weight and some people actually are born without them. So if he’s not in pain now he’s probably ok. But yes, terrible that they miss stuff like this.

If you’ve been discharged and no one will explain the MRI please go to PALS. Explain your situation. Sounds like something was missed and you have a right to have knowledge about what has gone on.