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PLAINVIEW, NY – Misdiagnosis of common foot and ankle injuries could have more consequences than you think.
A clinical review in the Journal of the American Osteopathic Association finds that misdiagnosis can result in poor long-term patient outcomes, including arthritis and disability.
The authors, led by researchers from Plainview Hospital, recommend that emergency physicians and other front-line providers consider using additional imaging and opting for second opinions such as an orthopedic consult when diagnosing six common foot and ankle injuries – snowboarder’s fractures (lateral talar process fractures), trigonum injuries, Lisfranc injuries, turf toes, navicular stress fractures, and syndesmotic injuries.
The article points out that more than 3 million emergency room visits in the United States each year are related to common foot and ankle injuries.
“These types of trauma are a clinically significant source of morbidity and long-term disability among patients, not just those who are elite athletes. In many cases, the clinical symptoms are vague and tough to detect with standard imaging,” explains lead author Jessica Reissig, DO, of the Department of Orthopedics at Plainview Hospital in New York. “As an osteopathic physician, I view treatment of foot and ankle injuries as acute and preventative care because a mismanaged injury leads to so many future problems for patients.”
Reissig emphasized that Lisfranc injuries and turf toe have a high correlation to future arthritis, as well as the potential for severe pain and disability years after the injury. Compensation injuries can occur as a result of improper treatment of other foot and ankle traumas and create issues such as tendinitis and recurrent ankle sprains.
Most of the injuries can be resolved with a combination of medication, immobilization, ice, and rest, but some require surgical intervention, especially if the patient is an elite athlete, added co-author Adam Bitterman, DO, of the Hofstra Northwell School of Medicine in Hempstead, NY.
“Once the diagnosis is confirmed, in many cases patients can be offered a range of treatment options from conservative to surgical,” Bitterman notes. “Choosing the best treatment for the individual can prevent the injury from decreasing the patient’s future quality of life.”