The Journal of the American Osteopathic Association Review highlights importance of additional imaging, second opinions for accurate diagnosis and treatment.

Front-line physicians are advised to err on the side of caution and opt for additional imaging and second opinions when diagnosing six common foot and ankle injuries. A new study by orthopedic surgeons finds misdiagnosis often results in poor long-term patient outcomes, including arthritis and disability.

Their clinical review, published in the February edition of the Journal of the American Osteopathic Association, outlined subtleties that complicate identification and treatment of snowboarder’s fracture (lateral talar process fractures) as well as os trigonum injuries, Lisfranc injuries, turf toe, navicular stress fractures and syndesmotic injuries.


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More than 3 million emergency room visits in the United States each year are related to common foot and ankle injuries. The authors encourage clinicians to be suspicious and obtain additional imaging or a second opinion from an orthopedic surgeon to confirm the initial diagnosis.

“These types of trauma are a clinically significant source of morbidity and long-term disability among patients, not just those who are elite athletes. In many cases, the clinical symptoms are vague and tough to detect with standard imaging,” said lead author Jessica Reissig, DO, of the Department of Orthopedics at Plainview Hospital in New York. “As an osteopathic physician, I view treatment of foot and ankle injuries as acute and preventative care because a mismanaged injury leads to so many future problems for patients.”

Read the full press release here.

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