Can the Xray be wrong?!

[Onthedoubleline]

Fell down steps yesterday, worst pain of my whole life (yes, including labour) through my right foot. It’s so painful, they were fairly convinced I’d broken it but then the Xray seemed clear. They didn’t do the ankle bones just the foot.

Im in so much pain and can barely put on the boot thing they gave me. I don’t know what to do tbh, I can barely move it.

Can this really be ‘ligament damage’ - that just feels like a PFO to me (Please F Off)

I feel like a total hypochondriac.

Yes they can be wrong

My Bil had broken his spine, but they missed it on the first xray (maybe due to too much inflammation I cant remember) and then they re xrayed it the next day and it showed up

There again ligament damage can be very painful?

I have had two fully sprained ankles and they were incredibly painful. Ligaments are agony. Mine each swelled up to twice the size of yours, and I could barely put the foot to the floor. I think you have to trust the diagnosis you’ve been given.

There may be an avulsion fracture, and in our dc's experience, no it wasn't picked up by an x-ray. It was eventually found after an MRI scan was examined by a senior sports injury consultant.

Not necessarily ‘wrong’ but fractures can be missed! I think if its that painful you should seek further medical advice.

I don't see any pinpoint bruising usually associated with a fracture, most likely a ligament issue which unfortunately is painful longer and takes longer to heal - broken bones heal faster and the pain, though high, usually goes away faster than a "soft" tissue injury. Bones heal in under 6 weeks, ligaments in 6 months.

@Onthedoubleline Yes, X-rays can be wrong, but yes, it can also be ligament damage. Some of the worst acute (not chronic) pain I’ve had in my life was when I tripped and took out my ankle. Turned out I’d ripped damn near every ligament connecting my foot (I think there were just enough to keep it on). I could barely put weight on, had an enormous bruise, ended up having to be in a fiberglass cast with no weight bearing for 6+ weeks, just as if I’d broken it, and finally do physio for a year. So don’t underestimate “ligament damage.” It can be absolutely terrible. If you remain unable to bear weight, push for an urgent MRI.

XR interpretation is a skill just like any other skill, and like any thing done by a human can occasionally be incorrect.
Everywhere I have worked (many places) has a system for checking XRs against the formal reports by the radiologists. If any fractures are missed the patient is contacted, this can some times take 24-48hrs,

Breaks can get missed. But I recently had a sprain of that nature. Very similar bruising pattern but more swollen. I couldn't beleive it wasn't broken either. I think 'sprain' was filed in my head as a minor thing that's synonymous with a twisted ankle, which is incorrect. If you spend some time researching the different levels of damage that can occur with a sprain I think the pain will make more sense.

Thank you everyone, I will speak to GP tomorrow I think it’s the ligament thing, I can’t bear any weight on it at all. I’ve already had 500mg naproxen and paracetamol today but it’s still throbbing through the boot.

Strains can be more painful than a break. I have a friend who turned her ankle on the start line of a half marathon and still ran the race. It turned out it was broken. I don't think she'd have run on a proper sprain.

Soft tissue inkuries are IMO much more painful than a fracture but yes it could have been missed in xray. DD broke her collar bone, was missed. Took her back a few days later and they could see it on the xray. TBF I could see it with the naked eye by that point.

I had a fracture missed when I was younger. Not completely but they thought I had broken one bone in my leg and I had broken 2 and a growth plate. This leg to my cast being removed and having it manipulated and re casted. If I hadn't communicated the pain then who knows the damage as they were trying to get me to walk on it (you can't walk on this fracture). Thankfully they sorted it out and my leg is fine now. This was a lonnnngggg time ago. It does happen and I would be tempted to go back.

I have also had ligament damage not in my foot though. It is very painful but I don't think it hurts to get a second opinion. Especially if they didn't x ray your ankle (did they say why they didn't?)

Poor you. I had an accident a few months ago and although one of the broken bones was picked up at A&E, the other 2 weren't until it was assessed by the fracture unit. (and then I was called back in again).

Did they say how long it would be until you had a call?

I broke my elbow as a child and slipping in ice. My mum took me to casualty and I had an X-ray. The doctor said it wasn’t broken and I was sent home in agony, no plaster, no sling. Weeks later my mum got a letter from the hospital saying the X-ray had been reviewed and my elbow had indeed been broken.

They can and do get it wrong. Hope you’re ok. It looks painful.

I think soft tissue can hurt more
I fell down 2 flights of stairs and broke my foot and ankle and it didn't really hurt!

Shredding my ligaments was far, far more painful than my broken foot. Same for the impressive bruising - bugger all with the break, loads with the "sprain".

I'm ten years down the line from the first nasty sprain and the foot and ankle have never been stable since.

Do you have any check ups booked?

I've had a number of injuries like this and agree it is agony. Nothing broken. A kind nurse told me that torn ligaments are much more painful than a clean break.

Ice, elevate and take whatever painkillers / anti inflammatories are recommended.

Wish you better.

I've had my entire ankle quite literally black all over. Alarmingly black but it wasn't broken. Conversely, I've had a broken ankle and not had any pain bar the initial hour or so after the incident. Can you move your toes the same as before?

I've had a ligament injury after falling downstairs that looked exactly like that and I needed crutches for about 4 weeks. Over 6 months later it still niggles. Ligament injuries can be worse than a fracture. I really hope you heal quickly

No they didn’t say why they didn’t, it’s like you don’t fall through the cracks anymore they are just huge chasms 😢

Not without a lot of pain across the top of my foot/ankle

Xrays are interpreted, so the report can be wrong or the fractures difficult to see immediatelyMy 3 hand fractures were not picked up on the first xray - I went to a different minor injuries unit after a few days and was re Xrayed. Having said that, ligament damage can be agonising.

DS1 was sent home from A&E with a boot for ligament damage, following X-rays. I had a call a couple of days later letting me know that they had taken another look at the X-rays and they concluded he had an avulsion fracture. The treatment was the same. Plenty of rest, painkillers as needed and wearing the boot for a few weeks.

My DM broke both her legs a couple of years ago. After the first set of X-rays was told nothing broken. After the second set of X-rays was told one leg broken. After the 3rd set of X-rays was told both were broken.
I think sometimes the images aren't taken well and some breaks or fractures can be difficult to spot.

I had a missed break in my ankle, so yes it is possible

I also damaged many tendons and ligaments at the same time and the pain was unbelievable