Os Trigonum? I hardly know him.
September 26, 2024 10:21 PM
Have you been diagnosed with an ‘os trigonom’ (an accessory bone that sits in the back of the ankle near the heel bone)? If yes, I’d love to hear more, especially if it’s been identified as the cause of other problems in the foot or ankle. Bonus points if you’re _not_ a ballet dancer or athlete, but I will take whatever I can get.
After _ a very long time _ , an apparently well regarded Dr. of Podiatry and ABFAS Certified Foot Surgeon diagnosed me (M, 50) with tendonitis in one or more of the following in either or both feet/legs:
- Peroneal tendonitis
- Posterior Tibialis
- Extensor Hallucis Longus
This was after X-rays (which found no problems with bones, and delighted him by revealing no loss of cartilage) and MRIs. He sent me off for 8 sessions of PT, after which I checked back in with him.
Upon learning (from the PT Dr’s writeup, and my report) that the course of PT had done very little to help, he said: “Er, you know, ahh, I just took another look at your MRIs, and see that you’ve got os trigonum, and that might be causing some stability issues that would explain blah blah blah” including, now, problems with the Flexor Hallucis Longus. He explained that the muscles or tendons which run down the back of and very close to the leg, behind the Achilles, can get impeded in some way leading to…. FHL tendonitis? I’m not sure really because he was unclear and clearly ready to move on to his next patient. Yes, really.
(FWIW: According to Dr. NotThorough, mine are larger than “normal”. I recorded in my notebook that he said the average is 1mm and mine is/are 6mm.)
So he has referred me to an ankle surgeon, to get — his words — “another pair of eyes on this”. I’m glad, because I have been unimpressed by his haste and lack of thoroughness since the first of three meetings. So I am seeing Dr. NewHope tomorrow (Friday). I am looking forward to it and going in with an open mind and informed approach, but wary that he might be a guy with a scalpel-shaped hammer looking for a particular type of nail. We’ll see. Given the titles of several of the papers he’s co-written, his interests seem diverse, not strictly surgical.
But I digress. YOU. (Even if you are indeed a dancer or athlete.) You have been identified as a member of the small portion of late-vintage primates who has one or two os trigonum. Has a medical professional found this to be causative for other problems you’d been having with paid caused when you stand, walk, hike, run, for any length of time?
Last … an interesting historical datapoint & a big part of why I am wondering about the likelihood that the presence and influence of the os trigonum is/n't playing a (significant) role amongst the various identified tendon/muscle problems: about 7 years ago, during the initial round of trying to figure out the cause of chronic foot and lower leg pain, I spoke to a Dr at Kaiser (I’m no longer with Kaiser). This was after undergoing the half dozen other tests one is required by Kaiser to do before one can get any imaging. Finally I was sent to a Sports Medicine Dr, who was not much more than half my age, and who took some X-days that revealed ...
(a) Os Trigonum ! ; and
(b) “various bone spurs in ankle joints”.
He was not concerned about either, which I believe was because they didn’t directly or simply explain where at the time I was feeling the most pain, which was in my calves and shins, not *as much* my ankles or feet which have since become the main location of pain. Currently I’m still having pain/tightness, after exertion, in calves and shins, which both Dr. NotThorough and Dr. Physical Therapy say is due to overcompensation for the foot/ankle problems instability. I mean, there are multiple areas of pain from just below the knees and on down, and yes MUCH TESTING for other causes has been done to rule out circulatory, pulmonary, metabolic causes.
Thanks!
After _ a very long time _ , an apparently well regarded Dr. of Podiatry and ABFAS Certified Foot Surgeon diagnosed me (M, 50) with tendonitis in one or more of the following in either or both feet/legs:
- Peroneal tendonitis
- Posterior Tibialis
- Extensor Hallucis Longus
This was after X-rays (which found no problems with bones, and delighted him by revealing no loss of cartilage) and MRIs. He sent me off for 8 sessions of PT, after which I checked back in with him.
Upon learning (from the PT Dr’s writeup, and my report) that the course of PT had done very little to help, he said: “Er, you know, ahh, I just took another look at your MRIs, and see that you’ve got os trigonum, and that might be causing some stability issues that would explain blah blah blah” including, now, problems with the Flexor Hallucis Longus. He explained that the muscles or tendons which run down the back of and very close to the leg, behind the Achilles, can get impeded in some way leading to…. FHL tendonitis? I’m not sure really because he was unclear and clearly ready to move on to his next patient. Yes, really.
(FWIW: According to Dr. NotThorough, mine are larger than “normal”. I recorded in my notebook that he said the average is 1mm and mine is/are 6mm.)
So he has referred me to an ankle surgeon, to get — his words — “another pair of eyes on this”. I’m glad, because I have been unimpressed by his haste and lack of thoroughness since the first of three meetings. So I am seeing Dr. NewHope tomorrow (Friday). I am looking forward to it and going in with an open mind and informed approach, but wary that he might be a guy with a scalpel-shaped hammer looking for a particular type of nail. We’ll see. Given the titles of several of the papers he’s co-written, his interests seem diverse, not strictly surgical.
But I digress. YOU. (Even if you are indeed a dancer or athlete.) You have been identified as a member of the small portion of late-vintage primates who has one or two os trigonum. Has a medical professional found this to be causative for other problems you’d been having with paid caused when you stand, walk, hike, run, for any length of time?
Last … an interesting historical datapoint & a big part of why I am wondering about the likelihood that the presence and influence of the os trigonum is/n't playing a (significant) role amongst the various identified tendon/muscle problems: about 7 years ago, during the initial round of trying to figure out the cause of chronic foot and lower leg pain, I spoke to a Dr at Kaiser (I’m no longer with Kaiser). This was after undergoing the half dozen other tests one is required by Kaiser to do before one can get any imaging. Finally I was sent to a Sports Medicine Dr, who was not much more than half my age, and who took some X-days that revealed ...
(a) Os Trigonum ! ; and
(b) “various bone spurs in ankle joints”.
He was not concerned about either, which I believe was because they didn’t directly or simply explain where at the time I was feeling the most pain, which was in my calves and shins, not *as much* my ankles or feet which have since become the main location of pain. Currently I’m still having pain/tightness, after exertion, in calves and shins, which both Dr. NotThorough and Dr. Physical Therapy say is due to overcompensation for the foot/ankle problems instability. I mean, there are multiple areas of pain from just below the knees and on down, and yes MUCH TESTING for other causes has been done to rule out circulatory, pulmonary, metabolic causes.
Thanks!
Sorry, ex-ballet dancer here, but dropping in with a data point to say that os trigonum was considered and investigated by my teacher and doctors as an explanation for my Achilles and tibialis posterior tendinitis. (X-rays revealed no extra bone bits)
posted by sixswitch at 5:27 AM on September 27
posted by sixswitch at 5:27 AM on September 27
I have os trigonum and it sucks. I have the least stable ankle, and I end up with a break in my lower leg every couple of years (I'm 51). I end up doing the boot then PT route. Ugh.
posted by heathrowga at 10:35 AM on September 27
posted by heathrowga at 10:35 AM on September 27
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posted by cotton dress sock at 1:43 AM on September 27