Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Ankle sprains are one of the most common musculoskeletal
injuries. Sprains are injuries to the ligaments of the ankle, causing
them to partially or completely tear as a result of sudden stretching.
They can occur on either or both of the inner and outer portions
of the ankle joint. Ankle sprains more commonly happen when there
is a preexisting muscle weakness in the ankle area or a history
of previous ankle injuries. The typical injury occurs when the
ankle is suddenly "twisted" in a sports activity or
by stepping off an uneven surface. The pain is initially severe
and can be associated with a "popping" sensation. Immediate
swelling over the area of injury often occurs as the injured blood
vessels leak fluid into the local tissue. Examination of the area
may cause severe pain when the ankle is moved. The degree of pain
may not necessarily indicate the degree of damage to the ligament(s).
Ligament injuries are often graded from I to III, ranging from
partial to complete tears. Partial tears retain some ankle stability,
whereas complete tears lose stability because the strapping ligaments
no longer brace the ankle joint. After an examination, significant
ankle sprains are commonly evaluated with an X-ray. X-rays
can determine whether there is an accompanying break (fracture)
of the bone.
Acute ankle sprains are initially treated with ice, rest, and limiting the amount of walking and weight-bearing on the injured ankle. The leg can be elevated to reduce swelling, and crutches are often recommended to avoid further trauma to the injured ligaments. Anti-inflammatory medications can be given to reduce local inflammation. Ice packs help decrease further swelling of the area and can reduce pain. Patients with severe injuries are placed in immobilization casts. Surgical repair of grade III injuries is considered, especially for those patients contemplating future athletic participation. Physical therapy programs are part of the rehabilitation process, incorporating strengthening exercises of the lower leg muscles. Broken ankles (fractures) can accompany ankle sprains or occur without sprains. Fractures are repaired with casting to immobilize the bone for healing. Depending on the severity, fractures can require orthopedic casting, surgical procedures including pinning, and open repair of the fractured bone.
Tendinitis
Tendinitis (also referred to as tendonitis) is an inflammation of the tendon. Tendinitis of the ankle can involve the Achilles
tendon, the posterior tibial tendon, or the peroneal tendon. This condition usually
results from trauma, such as from sudden injury in sports or overuse injury as from running but can result from underlying inflammatory
diseases or illnesses such as reactive arthritis (formerly called Reiter's syndrome), rheumatoid arthritis,
and ankylosing spondylitis. All forms of tendinitis cause pain,
swelling, and tenderness in the tendon area involved. The onset
may be rapid, such as with an athletic injury. Immediate treatment of tendinitis
involves immobilizing the area, elevation, and limiting weight-bearing, applying
ice, and using nonsteroidal anti-inflammatory drugs (NSAIDs) to
decrease inflammation. NSAIDs such as naproxen (Naprosyn) or
ketoprofen (Orudis) are commonly used for this purpose. More severe inflammation
can require orthopedic casting. Athletic participation should
be limited when the tendon is still inflamed, as there is a
significant
risk of rupturing or tearing the tendon, especially in the Achilles
area, with continued athletic activity. Achilles
tendon more frequently occurs in patients who have had previous
Achilles tendon inflammation. When the Achilles tendon ruptures, it usually
requires orthopedic surgical repair.
Ankle Pain And Tendinitis - Length Symptoms LastedQuestion: How long did the symptoms of your ankle pain and tendinitis last? Was there anything in particular that helped with pain/symptom relief?
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Carpal tunnel syndrome is a condition in which irritation of the wrist's median nerve causes tingling and numbness of the thumb, index, and the middle fingers. This condition is known as tarsal tunnel syndrome in the ankles and feet. Treatment of carpal tunnel syndrome depends on the severity of the symptoms and the nature of any disease that might be causing the symptoms.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Bone spurs are pointy outgrowths of bone that develop in areas of inflammation or injury. They commonly occur on the heel and spine and may be the result of reactive arthritis, ankylosing spondylitis, or diffuse idiopathic skeletal hyperostosis. Symptoms include pain, numbness, and tenderness. Treatment focuses on decreasing inflammation and avoiding re-injury.
Heel spurs, pointed, bony outgrowths of the heel, are caused by localized soft tissue inflammation and can be located at the back of the heel or under the heel, beneath the sole of the foot. Plantar fascitis is associated with inflammation caused by heel spurs on the soles of the feet. Both conditions are treated with ice application and anti-inflammatory medications. Orthotics may also provide some relief.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
There are several bones in the foot, and these bones can be broken (fractured) in a variety of ways. Falling from heights, dropping heavy objects on the foot, or stress fractures from running or walking. Treatment of a broken foot depends on what bone in the foot is broken.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Sever condition is an inflammation of the growth plate of the bone at the back of the heel where the Achilles tendon attaches. Sever condition can be very painful and is commonly referred to as "growing pains." The condition often disappears with age, but it can also be treated by limiting activity, using antiinflammatory medications, shoe inserts, and heel lifts.
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