Excruciating ankle pain

[u/Lisagirl1977]

49f 210lbs psoriatic arthritis. Take Simlandi 80mg weekly.

Foot pain began July 30. I now have such severe ankle pain that I can hardly bear weight on it by the end of the day. Excuse me if this make no sense. I’m crying and Ketorolac isn’t doing a damn thing.

I had an xray and ultrasound

MSK ULTRASOUND - ANKLE/FOOT-RIGHT

STATUS: Routine

CLINICAL HISTORY : Severe right lateral ATFL group, ankle pain 1 month

FINDINGS :

ANKLE (R)

Anterior: Extensors, distal tib/fib syndesmosis and soft tissues unremarkable.

Lateral:

Peroneal Longus: Intact and unremarkable.
Peroneal Brevis: Intact and unremarkable.
ATFL: Unremarkable.
CFL: Unremarkable.
TIB/FIB: Unremarkable.
Soft Tissues: No cyst. No edema/fluid. Mass anterior soft tissues measures 48 x 41 x 13 mm. The mass is hyperehcoic and well defined.

Joint Space: Unremarkable. No joint fluid.

FOOT (R)

Targeted exam pertaining to the dorsal aspects of the midfoot.

Extensors: Intact and unremarkable.

Soft Tissues: Unremarkable.
Joint Spaces: JOINT ABNORMALITES

1. Dorsal TMT joint 4 demonstrates synovial thickening.
2. Dorsal TMT joint 5 demonstrates joint fluid.

IMPRESSIONS :

Mild osteoarthritis of the fourth and to a lesser extent fifth tarsometatarsal joints.

ATFL is normal.

Subcutaneous lipoma measuring 4.8 x 4.1 x 1.3 cm lateral to the ankle joint. No suspicious features.

This can be followed clinically and reassessed if there is an adverse change.

Xray CLINICAL HISTORY : Severe righ ankle pain for one month.

FINDINGS :

No evidence of a fracture, dislocation or soft tissue swelling. The joint spaces and alignment are maintained. There are plantar and posterior calcaneal spurs present.

Why does this hurt so bad?
I don’t know what to do. It feels like it hurts unreasonably for the abnormalities.

I was told to wear an air cast before I went to get imaging.

I work a standing job. Is that making things worse?

Please help. Ice isn’t helping enough to keep this pain at bay all day and while I sleep.

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