Medial Ankle Bone Protrusion: Causes and Treatment Options

Prominence of the medial malleolus?

Hello, I have a prominent bone on the inner side of my right ankle, which appears to be an extra bone compared to others' ankles.
It hurts after walking for a long time, and there is a noticeable cracking sound when I rotate my ankle.
This has been going on for many years.
My left ankle also has a slight prominence, but it is not as pronounced as the right and does not cause pain.
What could this issue be? Do I need surgery?

😃😃, 10~19 year old female. Ask Date: 2016/02/20

Dr. Chen Yongxue reply Orthopedics

Hello, this is an accessory navicular bone in the ankle.
It is commonly seen in patients with flat feet.
Symptoms are usually more pronounced after prolonged standing or exercise.
Arch supports can be used for improvement.
If it does not cause excessive discomfort, surgery may not be necessary.
Thank you.

Reply Date: 2016/02/20

More Info

Medial ankle bone protrusion, often referred to as a bone spur or an osteophyte, can be a source of discomfort and pain, particularly during activities that involve prolonged walking or ankle rotation. This condition can arise from various underlying causes, and understanding these can help in determining the appropriate treatment options.

Causes of Medial Ankle Bone Protrusion
1. Osteoarthritis: Over time, wear and tear on the ankle joint can lead to osteoarthritis, which may cause bone spurs to develop as the body attempts to stabilize the joint.

2. Previous Injuries: A history of ankle sprains or fractures can lead to changes in the bone structure, resulting in protrusions or spurs.

3. Tendonitis: Inflammation of the tendons around the ankle, particularly the posterior tibial tendon, can lead to changes in the bone structure and the formation of bone spurs.

4. Biomechanical Issues: Abnormal foot mechanics, such as flat feet or high arches, can place additional stress on the ankle joint, leading to the development of bone spurs.

5. Genetic Factors: Some individuals may have a genetic predisposition to developing bone spurs or other bony protrusions.

Symptoms
The symptoms you are experiencing, such as pain during prolonged walking and audible clicking sounds when rotating the ankle, are common indicators of medial ankle bone protrusion. The pain may be due to irritation of surrounding soft tissues or inflammation caused by the protruding bone.

Treatment Options
1. Conservative Management:
- Rest and Activity Modification: Reducing activities that exacerbate the pain can help alleviate symptoms.

- Ice Therapy: Applying ice to the affected area can reduce inflammation and pain.

- Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the ankle, improve flexibility, and address any biomechanical issues.

- Orthotics: Custom orthotic devices can help correct foot mechanics and provide support, potentially alleviating pressure on the ankle.

2. Medications:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): If you are allergic to NSAIDs, alternative pain relief options such as acetaminophen or topical analgesics may be considered.

- Corticosteroid Injections: In some cases, corticosteroid injections may be used to reduce inflammation and pain.

3. Surgical Intervention:
- If conservative treatments fail to provide relief and the pain significantly impacts your quality of life, surgical options may be considered. Surgery may involve removing the bone spur or addressing any underlying issues contributing to the protrusion.

- The decision to proceed with surgery should be made in consultation with an orthopedic surgeon, who can evaluate the severity of the condition and discuss potential risks and benefits.

Conclusion
In summary, medial ankle bone protrusion can result from various factors, including osteoarthritis, previous injuries, and biomechanical issues. While conservative management is often effective, surgical options are available for those who do not respond to non-invasive treatments. It is essential to consult with a healthcare professional to determine the best course of action tailored to your specific condition. Regular follow-ups and monitoring can help manage symptoms and improve overall ankle function.

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