Clinical Assessment

The first step in the diagnosis of any foot and ankle problem is taking a comprehensive history and making a detailed clinical examination.  James has received expert training at Oswetry in the

assessment of foot and ankle problems and has used these skills to good effect as a Consultant for the last 5 years.

Investigations

After the clinical evaluation it is common to order some investigations. X-rays are often a useful start

may include Ultrasound, CT or MRI scans. These unfortunately need to be booked on a separate day.

Ultrasound Scan

Ultrasound scans are useful for investigating soft tissue problems such as suspected Morton's

neuroma. The ultrasound scan is performed by a consultant radiologist with specialist interest and

ankle.  This is the same test as a pregnant mother has to look at her baby. The test can take up to 20 minutes to perform. The test is usually not painful. This test needs to be booked and is usually

performed on a separate day.

Magnetic Resonance Imaging  (MRI) Scan

This scan is useful for assessing soft tissue, bone and joint problems. This scan uses magnetic fields to assess the tissues. The patient is placed into a tunnel for about 20 to 30 minutes. The tunnel is quite narrow.  You may not be able to have an MRI scan if you have metal or electronic implants. You

will be asked before hand if you are suitable for this scan and will be required to fill out a safety

questionnaire. Once the scan is performed James will receive the report within a few days. James will then either write, phone or see you in clinic with the results.

Computerised Tomography(CT) Scanning

This is a special scan using X-rays. The patient is placed into a short tunnel. Once the scan is performed James will receive the report within a few days. James will then either write, phone or see you in clinic with the results.

Diagnostic and Therapeutic Injections

Injections of local anaesthetic and steroid are used to help the diagnosis of foot and ankle problems. 

There are many joints and tendons around the foot. One or many of these may be a source of pain. It can be difficult to identify which of these may be causing the pain.
An X-ray doctor (consultant radiologist) will locate a specific area to inject with an ultrasound probe or using a special X-ray machine. The local anaesthetic acts to numb the affected area for a time lasting

few hours then the area injected is the source of that pain. This is the diagnostic part of the injection.

The steroid injection may relieve the pain for a longer period of time. The pain relief may last for a few