Severe pain in ankle, worst with high impact. i wear orthotics. worst in flat shoes. if i twist my ankle outwards its bad. 2 mri's, no results? ideas?

Many possibilities: Some causes of pain in the ankles can include systemic problems such as hypertension, gout, and problems with the kidneys and localized issues such as arthritis, infection, lymphatic obstruction, blood clots, varicose veins, trauma (fracture, sprain, and tendonitis) and side effects to medication. Have it evaluated by a professional and get the appropriate treatment.

You don't state: What the MRI showed. I will also say, I have found that i get "better readings" from musculoskeletal radiologists than a general radiologist reading a film. So you may want to make sure the MRI is being read by a musculoskeletal radiologist, if it is not showing anything.