Patient information

Before you come in.

Practical information for your first appointment, an explanation of the scans you might need, and how second opinions and video consultations work.

Your first appointment

A new consultation is a chance to understand exactly what's wrong and what can be done about it. Here's how to get the most from it.

What to bring

Your GP or referral letter, if you have one
If you're insured, your insurer's name, policy number and authorisation code
Any recent X-rays, scans or reports, and letters about previous treatment
A list of your medicines and any allergies
The shoes you wear most, plus any insoles or braces
Shorts or loose trousers, so both legs can be examined

What happens

A conversation about your symptoms, your health and what you want to get back to doing
An examination of both feet and ankles, including how you stand and walk
Dedicated imaging, such as an X-ray or scan, if needed
A clear explanation of what's going on and all your options, surgical and non-surgical
A written plan for you

Scans & imaging

Understanding your scans.

Many foot and ankle problems can be diagnosed from a careful examination and X-rays alone. When more detail is needed, Mr Jeyaseelan will explain which scan will help and why. Here's what each one involves.

Usually the first test

Weight-bearing X-ray

X-rays taken while you stand on the foot. Because the bones are carrying your body weight, they show how your foot and ankle really line up when you're walking, which an X-ray taken lying down can miss.

Why we use it

Bunions, flat feet and high arches, where alignment matters
Arthritis, by showing how much joint space is left
Fractures, and checking that they're healing
Planning surgery and comparing results over time

What's it like?

You stand on a low platform for a few quick pictures, usually from the front, side and above. It takes a few minutes. The radiation dose for a foot or ankle X-ray is very low, less than you'd receive from a day of natural background radiation.

No radiation

Ultrasound scan

Sound waves create live, moving pictures of the soft tissues just under the skin. Because the images are in real time, tendons and ligaments can be watched as you move your foot, and the two sides can be compared.

Why we use it

Tendon problems, such as the Achilles, peroneal and tibialis posterior tendons
Plantar fascia thickening in heel pain
Morton's neuroma, ganglions and other lumps
Guiding injections precisely to the right spot

What's it like?

Gel is put on the skin and a small handheld probe is moved over the area. It's painless, usually takes 15 to 30 minutes and needs no preparation. Ultrasound can't see inside bone, so it's often combined with an X-ray.

Detailed 3D bone pictures

CT scan

A CT scanner takes many X-ray images from different angles, and a computer builds them into detailed cross-sections and 3D pictures of the bones.

Why we use it

Complex fractures of the heel, ankle, talus and midfoot
Checking whether a fracture or fusion has fully healed
Planning complex surgery
Bony problems such as tarsal coalition

What's it like?

You lie on a table that moves through a ring-shaped scanner. The scan itself takes a few minutes. It uses more radiation than a plain X-ray, but because the foot and ankle are far from the body's sensitive organs, the dose is still low.

3D, standing up

Weight-bearing CT scan

A newer type of CT scan taken while you stand. It combines the detail of a CT scan with the real-life alignment of a weight-bearing X-ray, showing in 3D how your bones sit and move under load.

Why we use it

Flat feet, high arches and complex deformity
Bunions, including rotation of the bones
Subtle instability, such as high-ankle (syndesmosis) injuries
Planning ankle replacement and reconstruction

What's it like?

You stand in an open scanner for under a minute while it rotates around your feet and ankles. The radiation dose is usually lower than a standard CT. It's available at selected centres, and Mr Jeyaseelan can arrange it when it will help.

No radiation

MRI scan

MRI uses a strong magnet and radio waves to create detailed pictures of soft tissues and of the inside of bones, including problems that don't show on an X-ray.

Why we use it

Cartilage injuries in the ankle joint
Stress fractures and bone bruising
Ligament and tendon tears
Nerve problems, infection and soft-tissue lumps

What's it like?

You lie still with your foot in the scanner for around 20 to 40 minutes. It's noisy, so you'll be given ear protection. Please tell us beforehand if you have a pacemaker or other implant, metal fragments in your body, or feel claustrophobic. Many foot and ankle MRIs are done with only your legs inside the scanner.

Scans are arranged through dedicated imaging at the hospital where you're seen, and Mr Jeyaseelan will go through the results with you. If you're insured, check whether your insurer needs to authorise a scan first.

More ways to be seen

Second opinions & video consultations.

Second opinions

It's completely reasonable to want a second opinion. Mr Jeyaseelan regularly sees people who:

Have been advised to have foot or ankle surgery and want to be sure it's right for them
Have had surgery that hasn't worked as well as they hoped
Have a complex or unusual problem
Are unsure about a diagnosis or treatment plan

Please bring or send your previous letters, operation notes and scans, including the images as well as the reports. You'll get an honest, independent view of all your options, including non-surgical ones, in writing.

Ask for a second opinion When previous surgery hasn't worked →

Video consultations

Not every appointment needs a trip to the clinic. Video consultations are available for follow-ups and some first appointments, and are well suited to:

Going through scan or test results
Follow-up after treatment or surgery
Initial advice if you live outside London or abroad
Second opinions when you already have recent scans

What you'll need: a smartphone, tablet or computer with a camera, a quiet private space with good light, and shorts or loose trousers so your foot and ankle can be seen.

If you need an examination in person or a scan, Mr Jeyaseelan will tell you and you can book a clinic appointment. If you're insured, check that your policy covers video consultations.

Book a video consultation