June 15, 2018

Dr. Wood Explains the Role of Imaging with Ankle Sprains

Learn about how ARA Diagnostic Imaging can help diagnose when your kid might have a serious injury or a just a sprained ankle. Featuring Jeff P. Wood, MD.

ARA Sprained Ankles:

A: Welcome back to We Are Austin. School’s out for the summer, which means lots of time spent outside for kiddos. Unfortunately, that also can mean injuries increase as well. Dr. Jeff Wood, a Musculoskeletal Radiologist with ARA Diagnostic Imaging, is here to give us insight on a common athletic injury for children, and that is the sprained ankle. We’re glad to have you here.

Dr. Wood: Hi.

Anchor: That’s definitely a common topic over the summer. So, what is your medical specialty?

Dr. Wood: So technically, Musculoskeletal Radiology is what I do. I think sports radiology is a much easier term to go by. Everything from little kids that we’re going to talk about today all the way through college and pro athletes.

Anchor:  A little bit of everything. Okay, so do you see a lot of sprained ankles during the summertime?

Dr. Wood: That’s why I picked this topic. Obviously the most common thing. I heard Trevor talk about it as I walked by, how he had a bad injury as well. So very common and probably the most common thing we’ll see.

Anchor: Yeah, and it’s something that a lot of people experience at different phases and different ages.

Dr. Wood: Very much so.

Anchor: So, what steps should a parent take if they think that their child might be injured?

Dr. Wood: So, we’ll look here. This is a real common mnemonic or acronym that people can use. You can Google it if you forget. We say R.I.C.E., so Rest, Ice, Compression, Elevation. That’s going to be our first thing we’re going to try to do at the get-go.

Anchor: Okay, so what happens after that?

Dr. Wood: So, I always tell people, you know, friends that have kids, and they say, “When do we go to the doctor or when don’t we?”, and I always lead with this. You’re parents. If it’s bugging you, take them in.

Anchor: Trust your gut feeling, right?

Dr. Wood: Exactly! Otherwise if you don’t get quite a bit better after about a day of doing the RICE, I would say go in.

Anchor: Okay, let’s remind ourselves what was R.I.C.E. again. Rest, Ice, Compression, Elevation, okay, good. And when should you see a doctor? If that’s not helping, your gut feeling says that, or if you see swelling or discoloration?

Dr. Wood: Yes ma’am.

Anchor: So, if you do encourage people to see a doctor, where exactly should they go?

Dr. Wood: So, unfortunately, you don’t come straight to me. Most of the time we go to what we call primary care people. So, you guys will all have a pediatrician for your kid. If you’re a little bit older like myself, you tend to go to your primary care, urgent, or emergency room.

Anchor: Okay, so what are some different things that you see over the course of a summer?

Dr. Wood: Oh man, every which way. So, once we get to your primary care doctor, almost any of them are going to have a basic X-ray machine. That’s when I kind of enter the picture from behind the scenes. So, they’ll get X-rays and that’s where we start and we’ll go from there to MRI, CT, or sometimes even ultrasound for further diagnosis or if I’m going to do some sort of intervention or treatment.

Anchor: So, what are we looking at here?

Dr. Wood: This is cool, this is just a basic two-view of an ankle. This is a young kid because they still have a wide-open growth plate. This is the outside of your ankle, or what we call the lateral side. So, if you feel the bump on the outside of your ankle, that’s what that is. This is the medial side. This is from the side view or what we call the lateral view. You’re going to see the front of the ankle and the back of the ankle. This is your heel bone and this is where your Achilles and calf come in.

Anchor: These are healthy ankles, right?

Dr. Wood: That’s normal.

Anchor: Okay, good! I was like, that looks pretty normal–that’s what mine looks like! Okay, what’s happening here?

Dr. Wood: One of the things we look for if it’s not a sprained ankle is a fractured ankle. I think that ends up being what most parents are concerned about, but it’s very common. It happens every day, all the time, multiple times. In this picture, we see an X-ray and it’s actually hiding the same fracture; this is the same patient. So, we start with an X-ray and with a trained eye we see this very easily and very commonly. But the CT shows the ability of CT and why we do better imaging after X-ray. So, you see how easy it is there.

Anchor: Mhmm, so it was hiding and you can get more in-depth through that CT scan. What about here?

Dr. Wood: So here, I tried to zoom in for you. Here we’re starting off with a frontal X-ray and this is just a zoomed-in view. I don’t know if you guys can see here, but there’s just this tiny little sliver off that area. That actually is a small fracture off of this bone, and this is a really, really common injury. Here we have the main ligaments that we’ll talk about in just a second, but this is the most common ligament that we’re going to injure. This here, we actually pulled off the bone instead of tore the ligament.

Anchor: Interesting. Yeah, so as we wrap up here tell us what you see here with the common ligament you’re talking about.

Dr. Wood: Yeah, I apologize. This is the most common injury when you say you’ve sprained your ankle. 90% of the time this is going to be it. So, this is actually a cut through here and we’re looking down this like a loaf of bread. This is a normal ligament–this orange here–and this one is torn. This is an MRI, so this is a much higher-level study that we would do after an X-ray if it didn’t get better.

Anchor: Yeah, and this is what you’re doing all day every day because you’re an expert.

Dr. Wood: Often.

Anchor: How can people come see you if they find themselves in need this summer?

Dr. Wood: Fortunately, we cover most of town through ARC, Seton, and the University of Texas Healthcare. We work here with ARA and almost all of your primary care doctors are going to get with us. The number’s on the screen to know for diagnosis.

Anchor: Thank you so much for being with us this morning and thanks for all that info. Poor sweet, little ankles of all those kids out there—we’ve got to take care of them! I feel really informed–thank you.

Dr. Wood: You’re welcome.

Anchor: You have the info there if you want to give them a call and learn more.