Jones Fracture questions

On 7/14, my wife suffered a Jones fracture of the 5th metatarsal, left foot.
http://users.rcn.com/rsmit999/random...-foot71508.jpg

She was placed in a walking boot. According to subsequent x-rays at 2 weeks and 4 weeks, she was healing well.

On 9/1, she tripped over something in our home, and was in severe pain, this time toward the anterior end of the same 5th metatarsal and the rest of the forefoot, with a new tingling sensation along the entire plantar surface. X-rays that day proved negative. She went back in the boot for two weeks, and with pain greatly reduced (but tingling remaining), she was cleared to start PT. http://users.rcn.com/rsmit999/random...FOOT-91508.jpg

Two weeks later, her PT had a "technician" overseeing the therapy, including a new exercise. After this session, my wife could barely walk due to forefoot pain. This improved a bit with ice, but two days later when the PT examined her foot, she thought she detected a neuroma between 3rd and 4th metatarsal. Went back to ortho, who could not detect it with palpation.

Since then, she has 1) gotten a second opinion from another ortho who had no new input 2) started using metatarsal pads in her shoes, with intermittent improvement and 3) had an MRI, which showed no neuroma, but the report summary was as follows...

Diffuse patchy marrow edema throughout the metatarsals and tarsals, most prominent within the 1st and 5th metatarsals, as well as the cuboid and calcaneous. No underlaying fracture or TI signal abnormality is present. This finding is nonspecific and may represent altered biomechanics.

The ortho has not provided feedback yet (he gets the report tomorrow).

Is this situation where it is simply fluid buildup that should resolve with PT, massage or Active Release Therapy, or should another avenue be explored?

Thank you!
Rob

[FootDoc]

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As I see it, you present a number of pieces of information with what I sense may be the implication on your part that they are materially connected. Keep in mind that, in my experience, a radiologist frequently tends to attempt to demonstrate that he/she is earning his keep by a recitation of descriptive findings even when they are not necessarily productive to a clinically meaningful diagnostic conclusion regarding the patient's complaint. But, especially to base any real diagnostic value upon which real decisions might be base on an MRI which concludes that the findings are non-specific, and to then consider that those finding need to be addressed by the attending, is often a non-sequitur. It is beyond reasonable expectations that someone who has neither examined you or attended your case could offer a responsible answer to your bottom line question.

I try, but cannot say it often enough or loud enough that forums such as this are inappropriate venues for offering case-specific comments which can be counted upon in individual situations. Leave these questions to your attending orthopedist who actually knows you and your case.

Granted, that is not the response for which you came here, but my professional responsibily and ethics trumps the desires questioners.