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.

I tripped at the beginning of January and the xray was clear - they just xrayed my foot. After 6 weeks I was still in a lot of pain and my foot was still swollen, so I went to a diagnostic physiotherapist for an ultrasound - it cost £120.

The ultra sound showed a 2nd degree tear of the posterior tibialis tendon in my ankle and also ligament damage. He said to do tip toe exercises and the recovery was usually 12 to 14 weeks. It's almost better now and I think it was money well spent.

Thanks all so much for taking the time to reply to this I really appreciate it x

I'm surprised they didn't x-ray both ankle and foot.

But I sprained my ankle and couldn't weight-bear on it at all for weeks. I was on crutches for ages and it took about 6 months to get back to normal and 2 years before twinges stopped.

It may be wrong, but spraining one's foot is incredibly painful! I fell down the stairs 6 months ago, was screaming with the pain. However it wasn't broken, and I took a Naproxen as I have some on hand for back pain, and that really brought down the level of pain, plus using cold packs on it (gingerly as even that hurt). I couldn't put that foot down for a few days and used a crutch for a week to avoid accidentally doing so.

Hope you feel better soon, OP!

When my mother broke her elbow, the radiologist initially misread the x-ray. This admittedly wasn't in the UK.

I had a missed ankle break as a child. I only found out 20 years later when I broke that same ankle and they said I had broken it before and asked when. I told them I hadn’t, I’d had a sprain. They showed me the healed fracture that was still quite clear.
Apparently swelling can push the fracture closed enough that it can be missed.

That said, soft tissue injuries such as ligaments can cause major swelling and bruising.

DH had his broken collar bone missed on an x-Ray. He was sure he’s broken it, so the following day we phoned 111 and they made him a timed appointment at a hospital, a different one, that morning. Very efficient. He had broken it.

Severe ligament damage can be more painful and cause more bruising than a fracture. If you have ruptured a ligament it can take months to heal.

I had something similar..fell down the stairs and hurt my leg about the age of 9. X-ray showed no fracture but ‘evidence of an old injury that had healed’ and my Mum gasped ‘When did you really hurt yourself and I didn’t believe you?!’ 🤣 she was a nurse and notorious for telling us we’d be fine!

The x-ray won't be wrong but the interpretation could be.

Sorry, pedant radiographer thinks she's funny moment.

Anyway, not allowed to give opinions on social media obviously but lovely bruise/swelling there, always nice to see someone putting the effort in before they come to hospital. I can see why they went for midfoot not ankle. The x-ray will be reported on top of your visit to you might want to get in touch/pop back if it's still super painful in a couple of days (advice I give as a human with tonnes of kids not a radiographer!).

Although sometimes doesn't matter if a fracture is visible on an x-ray, it still hurts to buggery and is slowing you right down which won't change however the image is interpreted, look after yourself and hopefully it will start to get a lot less painful soon.

Sorry to say but ligament damage can often be more painful and take longer to heal than a fracture

There may be an avulsion fracture, and in our dc's experience, no it wasn't picked up by an x-ray. - this is what happened to me. One fracture was seen on x-ray, but the other missed. When they took off the plaster I still could not put my foot to the floor because of the pain.

Eventually I saw someone privately who studied the x-rays at length and said that I had a second avulsion fracture which has pulled the end off my heel bone and it has been missed. I was offered surgery to fuse all the bones in my foot, but warned that this would cause ankle problems further down the line. In the end they plastered it for a further 8 weeks. I am still in pain with it 12 years later and use a stick when walking outdoors.

An avulsion fracture is agony because the ligament has pulled the piece of bone off, and is therefore damaged itself, so you have both bone and ligament damage.

The fracture I had is commonly missed on x-ray. If things do not improve then you need to go back. Feet are fiddly with many bones - they are also very precious for future mobility as I know to my cost.

Thank you for responding as a radiographer, I still feel there’s something off here but the GP told me that the report says no so here’s some pain drugs now go away. I can’t bear any weight but I appreciate what everyone has said about soft tissue pain.

An X-ray failed to pick up my kneecap break as a teenager, it was only when I had a further investigation done in preparation for an op on it (I was prone to dislocations) that the break was spotted!

Hope you're feeling better soon Op x

I would be concerned (perhaps wrongly) that they didn't x ray your ankle where the bruising is. If they only X-rayed the foot surely a broken ankle could have been missed?

The only time I have ever cried in pain was when I sprained my ankle

Torn ankle ligaments are by far and way the most painful thing I've ever experienced including bone breaks and childbirth!

Ive done both at the same time, ligament in one ankle, fracture in the other - there was no real difference in pain levels, or in the treatment

I have both broken and sprained my ankle (at different times). The sprain was more painful x 10 - it's the closest I've ever been to passing out - full on sway, everything went fuzzy and slow and I zoned out for about ten seconds. Absolutely excruciating.

With my break, I was back on my feet and totally healed 8 weeks later. With the sprain I was still getting niggles and pain if I bent a certain way for about two years.

Don't underestimate how painful a 'not broken' injury can be. Hope it's feeling better soon op x

When everything is swollen, it can be difficult to see clearly on an x-Ray. I hurt my foot, the break only showed up on the second x-Ray.

I got called back when they missed a fracture in my foot on first look. Having said that, I’ve broken my foot twice but also tore three ligaments in my ankle (at same time). The latter was by far the worst injury. You will need an MRI for that though so if pain continues I would go back. My GP refers straight to musculoskeletal unit who then organises MRIs but not sure if that’s the same everywhere.