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.
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.
and can usually be ordered and assessed on the same day as the consultation. Further investigations
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.
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.
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.
skills in this area. The ultrasound scan involves the placement of a probe and jelly across the foot /
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
up to 24 hours. The steroid can provide some long lasting pain relief. If the pain is relieved even for a
days, weeks, months or even longer. The length of pain relief is unpredictable.
If the pain relief lasts for a few hours or days then returns the injection has still been useful. If the pain
has not been totally relieved then the source of the pain may be somewhere else. In this situation than further injections may be necessary to locate the source of the pain.
If the injection has produced pain relief but the pain has returned then a surgical intervention may be
necessary to produce a more long lasting pain relief. I will assess you in this situation and be able to
advise on an individual basis.