Ankle Sprain: Persistent Bump on Outer Foot After Two Months

Ankle sprain with swelling on the outer side of the foot?

After a sprained ankle, the swelling has subsided after two months, but there is a noticeable bump on the outer side of the foot, close to the fifth metatarsal.
There is no pain during normal walking, but there is discomfort when jogging and when pressure is applied.
An X-ray was taken by an orthopedic specialist, and no abnormalities were found.
Is it necessary to get another X-ray?

Kai, 10~19 year old female. Ask Date: 2021/02/02

Dr. Chen Bochen reply Orthopedics

You may consider visiting an orthopedic or rehabilitation clinic for an ultrasound to clarify what the protrusion is.
X-rays do not need to be repeated within a short period of time.

Reply Date: 2021/02/02

More Info

Ankle sprains are common injuries that can lead to lingering symptoms, even after the initial swelling has subsided. In your case, the persistent bump on the outer side of your foot, near the fifth metatarsal, is concerning, especially since you experience pain during activities like running or when pressure is applied. Although the X-ray results showed no abnormalities, there are several factors to consider regarding your condition.

Firstly, the bump you are experiencing could be due to several reasons. One possibility is that it could be a residual hematoma or a localized swelling that has not completely resolved. Sometimes, after an ankle sprain, the soft tissues around the joint can remain inflamed, leading to a palpable bump. Another possibility is that there could be a small bone bruise or a stress reaction that may not be visible on an initial X-ray. In some cases, a fracture may not be evident immediately after the injury, especially if it is a hairline fracture or if the X-ray was taken too soon after the injury.

Given that you have been experiencing discomfort during specific activities, it may be prudent to follow up with your orthopedic specialist. They might recommend a repeat X-ray or even an MRI to assess the soft tissues and bones more thoroughly. An MRI can provide a clearer picture of any potential soft tissue damage, such as ligament tears or tendon injuries, which are common in ankle sprains.

In terms of management, if the bump is indeed due to soft tissue swelling, conservative treatment methods such as rest, ice, compression, and elevation (RICE) can be beneficial. Additionally, physical therapy may help strengthen the surrounding muscles and improve stability, which can alleviate pain during activities. A physical therapist can also guide you through specific exercises to enhance your ankle's range of motion and strength.

It's also essential to consider the possibility of a chronic ankle instability, which can occur after a significant sprain. This condition can lead to recurrent sprains and persistent pain if not addressed properly. If you find that your ankle feels unstable or gives way during activities, this is something to discuss with your healthcare provider.

In conclusion, while the absence of abnormalities on the X-ray is reassuring, the persistent bump and pain you are experiencing warrant further evaluation. A follow-up with your orthopedic specialist is advisable to determine the best course of action, which may include imaging studies and a tailored rehabilitation program. Remember, it's crucial to listen to your body and avoid pushing through pain, as this can lead to further complications down the line.

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