RSD/Post Traumatic Arthropathy
 

Hello!
I hope someone can help, as I am in pain, and the waiting to see Doctors is getting beyond a joke.
Back in June 2008, I was involved in a MVA, due to a car failing to give way at an intersection.
We hit the other car head on, and both my feet hit the floor of our car, almost like I was hitting imaginary brakes. I felt something snap in my left foot, and when the ambulance staff helped me from the wreck, I found I could not walk, the pain was like 12 out of 10!!
I had both feet xrayed at the hospital, and to my amazement, nothing showed!
So I went home (I had other injuries...), and for about a month, I crawled around the house on my hands and knees, as I could not use my feet, and to use crutches was unbearable, as I had injured my shoulder blades, and could not support myself on them. Basically, getting around was almost impossible for at least 4 months after the crash. The right foot recovered, even though even now, it does swell up, but the left remained unchanged and very painful.

Finally, I saw an Orthopaedic Surgeon, and I had more x-rays and MRI done. The MRI said I had a suspected avulsion fracture, and with all the odema in the foot it was hard to acurately say what was wrong.. eventually the Ortho said I may have CRDS. I had never heard of it, so I did not believe what he was saying. He sent me to a pain clinic, who advised my GP to start me on Tegratol for the spasms in my foot (Which were uncontrolable and OH SO painful...), and Oxycontin for extreme pain (5-10mg once a day)
My GP refused to give me the Oxycontin, as he said it was habit forming, and not very nice. So all I have had in the last year is the tegratol and asprin...the pain btw, is so bad..I feel clicking and unusual grinding inside the foot. I can't stand on my left foot with the right one not on the ground..I can't bend the foot much at all, and after a year, I am VERY concerned.

I have to wait for another appointment to see the Ortho surgeon, as he sent me for a bone scan.
These are the results:

The medial Cuneiform activity is quite linear.. and related to the cuneometatarsal joint on the delayed images particularly on the medial views. There is some low grade activity involving the medial cuneiform and adjacent to the of base 1st metatarsal . These appearances raise the possiblity of Post Traumatic Arthropathy rather than residual or healing stress fracture or fracture associated with the previous MVA. Associated synovitis around the left midfoot.
On the delayed images, abnormal activity involving the left medial cuneometatarsal joint, with low grade midfoot activity in the region of the 1st to 4th TMT joints, and overlying the cuneiforms consistant with some low grade synavitis. There is low grade activity at the 1st MTP joint on the left in keeping with low grade arthropathy. Low grade Plantar facitis on the right foot. Probable vascular activity accounting for vocus of activity in the posteromedial soft tissues in the right mid-calf.
The initial flow and blood pool images demonstrate hyperaemia around the left midfoot, particularly in the region of the medial cuneiform with some low grade activity involving the intermediate & lateral cuneiforms and in the region of the distal shaft of the 2nd metatarsal.

I do hope someone can help! :)...sorry about the size of this!

Have you seen a neuro? If not I would go. I am not sure of the bone scan results but regardless I would see a neuro. My gp's and that is a few of them I have found are not too happy about working with meds and it is very improtant to hav a good pain doctor who deals a lot with rsd. Though some here do have good gp's. What was your mri of? I know when I had been to the ortho in the start of this and many of my tests showed little I was refered to a neuro. I was then dx through emg/nc etc with pn and then rsd. Also your current pain treatment and I am not on any narcotics but am on more meds lik neurontin after failed treatments like nrve blocks sounds like it needs adjustment. Have you had any pt and or tried things like neurontin,etc? Hang in there. Also I know the wait for docs and my best advice is to call every day for a cancelation. I have gotten in a month in advance before.

You REALLY need a pain management doctor. They are very familiar with this type of pain, and will help you find a way to cope with it. A lot of them are actually anesthesiologists, and they specialize in stopping the pain. They are more comfortable giving you medication that will help than a GP might be. I had the same thing happen to me 4 years ago. Car accident with a drunk driver, severe pain, but nothing showed on the x-rays. Eventually had an MRI and a bone scan 6 weeks later that showed fractures in my ribs and torn ligaments in my ankle, but after seeing an ortho and having surgery on my ankle, everything looked healed even on MRI. I was still in a lot of pain. I was sent to a pain management doctor, and he figured out that I have RSD 16 months after the surgery. Don't think you have to deal with this on your won. Get another opinion. Good luck.

AM

Wendy: I do agree with the others on this one. You cannot sit back and wait to get an apt. The best pace to start is with a good pain clinic or a good neuro Dr. If you have a good GP and you trust him or her,they are a very big help in getting you in early to see the above DR's. You cannot crawl around on your knees all day and night! Also how can you stand to be in that much pain? I do not care what the Dr said he is not living your life or fealing the pain that you are in right now! Life is not always based on the answers we receive,but also on the questions that we ask. Take Care! Fight For All Of Us! We Are Here For You! Breezy55 :hug: :Good-Luck: