Question
Thank you for your time. After a year of intra-articular steriod injections, and lots of physical therapy I was still having pain from a nasty ankle sprain (occured March 2005). I've sprained this ankle several times in the past, but never this bad before. Throw on top of it the fact that I'm in the military and the problem wasn't properly addressed by my primary doctor until two months after the initial injury. In January an MRI was performed. The report came back showing an increase in signal/fluid intensity and synovitis within the anterior ankle. My podiatrist opted to perform a synovectomy to remove the build up, but never ordered tests on any of the tissue/fluid removed. During the operation he also examined the inner cartiledge and found it to be intact. That surgery was in February. I followed all instructions, but still have very limited range of motion (as measured by the physical therapist), swelling, stiffness, pain during impact exercises, and have started experiencing short 20 min episodes where my foot gets extremely cold and numb. Contrast baths and massage have helped the last problem somewhat. Throughout this entire ordeal I've also had a thick mound of flesh below my right ankle 'bone' that hurts when pressed. For pain I've been given naperson and 1000mg motrin, neither of which do much. My frustration is the fact that because I am military overseas I am limited as to what kind of specialists I can see. My doctor has been preparing to leave and return to the states, which means his replacement will be here soon. I'm trying to learn as much as I can so I'm better prepared with questions when his replacement arrives. So far getting a consultation with a doctor outside my base network has been fruitless. Thank you once again for any advice you may have.

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Followup To

Question -
Is it routine for a surgeon to request tests on fluid/tissue collected from a synovectomy?

Answer -
Please give me more information on why the synovectomy was performed.  

Typically, when tissue/fluid is removed testing is performed to help with a diagnosis or to confirm a suspected problem. If you have arthritis, the tissue may be checked to confirm changes that are common, such as inflammation.

I can be more specific if I have more info.  Hope that helps for now.

Answer
Jennifer, sorry you're having such a tough time with your ankle.  

If you had synovitis on MRI, you would not necessarily send pathology or fluid after synovectomy since the cause was known.

Unfortunately, after a severe ankle injury, the healing time can be many months or longer especially if you are active.  In addition, you had further trauma by having your joint opened.   

You will likely need to continue physical therapy for a prolonged period and will require some type of custom ankle brace/stabilizer to assist with healing.  Muscle strengthening around the ankle is essential.  

If you continue to have problems, another MRI would be reasonable to reevaluate the area.  Also, I would try and get a second opinion.

Hang in there and continue with therapy.  If you have any other questions as treatment continues, drop me a note.

You can check my website for information on ankle conditions and surgery.  http://www.theTampaPodiatrist.com