Told You I Was Fancy, Pt. 2

What. On. Earth.

Okay, so Giles and I visited the Musculoskeletal Oncologist yesterday to learn the results of my left foot MRI.  Let me start out by saying it does not necessarily bode well for the patient when the doctor is bright-eyed and bushy-tailed, excited to talk about your case.  It means your case is interesting.  "Interesting" for a scientist means "different" and "unusual" and a "mystery."  These are words most of us do not want attached to our medical charts.

First off, the MRI showed no cancer.

The MRI did show melorheostosis.  The MRI also showed osteonecrosis in the distal 2nd metatarsal.

Yes, kids.  You read that right.  Bone death.

>insert thrashing around in a toddler-worthy temper-tantrum<

I have osteonecrosis in the distal end of the 2nd metatarsal, specifically called "Freiberg's Infraction."  It is a non-invasive (not going to spread) sclerosis.

It does not appear to be from a recent injury because there is no swelling.  His best guess is it appears to be from a long-ago injury that caused the tip of the bone to die.  His best guess is that it was brewing in my bone and running made it worse.  Typically, Freiberg's Infraction heals itself.  The healing causes pain and discomfort.  This explains the random, floating pain.  It explains the entirely unpredictable pain.  It explains the weird (and deeply annoying) numbness and other nerve-related tingles.

He said he has not seen Freiberg's Infraction in several years and that this is now in the domain of a sports medicine orthopedic surgeon who specializes in the foot and ankle.

So what do I do now?  Well, he wants me to see the foot/ankle specialist within the next month.  He said basically we are now in a "watchful waiting" stage.  I have an appointment with the foot/ankle guy next Friday.  In the meantime, I have strong pain meds.

Among the options the foot/ankle doc might choose is an insert for my shoe that contains a bar that would run under the metatarsals.  The bar would redistribute weight and pressure on the metatarsals.

I did some internet searching on our drive home and learned that Freiberg's typically hits young women and teen girls.  Sometimes it is brought on by an injury or high doses of steroids. Sometimes it is caused by the second metatarsal being too long and sustaining too much pressure. There are some brutal-sounding operations available that I am entirely uninterested in pursuing.  Hopefully, this is something that occurred years ago and running merely aggravated it.  At the same time, my internist thought I had asthma for three years prescribed very high doses of oral steroids to control it.  Turns out I do not have asthma, but vocal cord dysfunction and do not actually need inhalers.  Could the steroids have caused the Freiberg's?

It is highly interesting to me that this is the same bone with melorheostosis.  The oncologist believes they are entirely unrelated.  I question that conclusion.  What are the chances that I would have two highly unusual conditions in the same bone?

At any rate, the mystery continues.  To date, we have two x-rays, 1 bone scan, 1 CT scan, and 1 MRI of my left foot.  We'll know more next Friday.

Told you I was fancy.

But this is getting old.  Really, really (really) old.