Loved the new ankle guy. Didn't hurt that he was cute and said, "Have we met before? You seem familiar," and totally GOT that I am a runner. He looked at the xrays I brought from September, and said the report was wrong. The report said the left ankle was normal, no damage. He said, not so. The ankle joint actually is ok, but the talonavicular joint has joint space narrowing (sign of RA) and a small erosion.
OK, hands up, who knew you even had a talonavicular joint?? But so cool, click here to see ALL your ankle joints in motion!
He was irritated that it had initally been read wrong, and said he might write the radiologist a note...I said, "Please, do it!" That's not the kind of thing I want misdiagnosed. And, yet, the first ankle guy I saw didn't mention it either. Hmm. But I trust this guy more. And he explained all kinds of things to me and answered all my questions, so I didn't even really mind that my 3:15 appointment didn't start unil 4:00. He did mention at the end that it was possible this was NOT an RA issue, but it is. I tried to explain that I couldn't explain, but I just knew. Then in my research tonight I found this that says it's actually a common joint affected by RA. I feel like my knowledge of my foot expanded about 100% today.
The talonavicular joint is what moves the ankle side to side. My up and down range of motion is pretty ok, but side to side I have little, it's very very stiff. Not a big deal for running and cycling, luckily! He didn't bat an eye when I said I've run a few marathons and am very active, whereas most doctors will sort of imply that I should give it up if it hurts. He didn't. He had a plan to try to accommodate me.
Anyway, here's what he said. He said if I really want the cortisone injection, he will do it...once. It's a tricky place to do it, and there are tendons and things in the way, but he respected my wish to try it and see. But he suggested first that I see the podiatrist in their group for orthotics that can actually take the pressure off and stabilize that joint. So I'm going back next Wednesday for that, and we'll see. Nice to know I can have the shot as back up. And as an extreme back up, that joint can be fused, meaning I would lose all side to side range of motion but shouldn't ultimately affect running. Not that I see doing that in the next 10 years, but I feel much better having all my options laid out and being told that it's my decision.