During the physical exam, your doctor will check for points of tenderness in your foot and ankle. The precise location of your pain can help determine its cause. He or she may move your foot into different positions, to check your range of motion. You may be asked to walk for a short distance so that your doctor can examine your gait.
Not all foot and ankle injuries require imaging. If your signs and symptoms meet certain criteria, your doctor may suggest one or more of the following imaging tests.
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- X-rays. Most ankle and foot fractures can be visualized on X-rays. The technician may need to take X-rays from several different angles so that the bone images won't overlap too much. Stress fractures often don't show up on X-rays until the break actually starts healing.
- Bone scan. For a bone scan, a technician will inject a small amount of radioactive material into a vein. The radioactive material is attracted to your bones, especially the parts of your bones that have been damaged. Damaged areas, including stress fractures, show up as bright spots on the resulting image.
- Computerized tomography (CT). CT scans take X-rays from many different angles and combine them to make cross-sectional images of internal structures of your body. CT scans can reveal more detail about the bone and the soft tissues that surround it, which may help your doctor determine the best treatment.
- Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to create very detailed images of the ligaments that help hold your foot and ankle together. This imaging helps to show ligaments and bones and can identify fractures not seen on X-rays. These more advanced imaging studies are normally used in people whose occupations require them to be active on their feet, such as athletes.
- Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed Dec. 13, 2013.
- Miller MD, et al. Essential Orthopaedics. Philadelphia, Pa.: Elsevier Saunders; 2010. http://www.clinicalkey.com. Accessed Dec. 13, 2013.
- Ankle fractures (broken ankle). American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00391. Accessed Dec. 11, 2013.
- Toe and forefoot fractures. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00165. Accessed Dec. 11, 2013.
- Stress fractures of the foot and ankle. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00379. Accessed Dec. 13, 2013.
- DeWeber K. Overview of stress fractures. http://www.uptodate.com/home/index.html. Accessed Dec. 11, 2013.
- Ferri FF. Ferri's Clinical Advisor. 2014. 5 Books in 1. Philadelphia, Pa.:Mosby Elsevier; 2014. http://www.clinicalkey.com Accessed Dec. 11, 2013.
- Once is enough: A guide to preventing future fractures. NIH Osteoporosis and Bone Diseases National Resource Center. http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Fracture/. Accessed Dec. 13, 2013.
- Chen YT, et al. Update on stress fractures in female athletes: Epidemiology, treatment, and prevention. Current Reviews in Musculoskeletal Medicine. 2013;6:173.
- Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 17, 2013.
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