Monday, January 11, 2010


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.


Kristina said...

Oh my goodness, that is the exact same joint that bothers me! It doesn't ALWAYS bother me, but has been so bad that there were days in a row that I couldn't walk on it at ALL. My rheumatologist (who stinks and I am never going back to see him) acted like it's no big deal. THAT I COULDN'T WALK! Yeah.

Awesome that you found such a great doctor!

jsmarslender said...

I'm so glad you met the new ankle guy and that he had some answers and explanations for you. It makes such a difference to speak with someone who understands your activity level and what you want too; someone who will lay out options so that you can be well informed. I had an appointment like that a few years ago, where I finally found a doctor who clearly explained what was going on in my calve muscle and I thought: how did the others miss this!? I hope the orthotics make a difference.

Angela and David Kidd said...

THat's great that you have doctor that understands you! It makes a huge difference. Hopefully the orthotics help.

Cobble Hill Mom said...

Hi Claire, I just started reading your blog which I found in a roundabout way through two other blogs, one of which was on Runners World. I was just diagnosed with RA, and I am so happy to finally have my diagnosis. I am a runner, too, and my RA pain began in September with wrist and hand pain then massive right foot problems. It spread throughout my body to me knees and upper back, and I also started getting the fevers in November, but now it is under control with prednisone. I'm taking that daily and methotrexate once a week. My Rheumatologist said it will take between 6 - 8 weeks before the methotrexate starts working, but the prednisone keeps my symptoms at bay. As much as I'm not happy being on it, I've finally been able to start running again! Only 10 minutes, but that's something. Anyway, thanks for your inspirational blog! I'm looking forward to getting the disease under control and resuming my competitive running. Hope you're ankle feels better. Mine goes up and down, but this round of prednisone (7.5 mg) is really helping! Jessica

nancy said...

WOW!! Ijust found your blog, and am blown away by your info on this joint. I have had RA mainly in my feet for 10 years, and have never been told specifics.

My ankles will roll severly if I even step on a small rock. You have no idea how much I appreciate this info! My drs have not been the best. : (