Best Practice Case Studies-Case 113 Ankle - "INVESTIGATING ACUTE ANKLE PAIN"

Pdf Summary

<h2 data-end="183" data-start="139" data-section-id="1ui3x7v">Differential Diagnosis</h2>
<ul data-end="1105" data-start="185">
<li data-end="362" data-start="185" data-section-id="3u9hfc"><strong data-end="230" data-start="187">Stress fracture of the medial malleolus</strong>
<ul data-end="362" data-start="235">
<li data-end="273" data-start="235" data-section-id="2hul0l">High-risk stress fracture location</li>
<li data-end="327" data-start="276" data-section-id="evr5t1">Pain with weight-bearing, often insidious onset</li>
<li data-end="362" data-start="330" data-section-id="3xpgez">May have normal early X-rays</li>
</ul>
</li>
<li data-end="569" data-start="364" data-section-id="28smql"><strong data-end="394" data-start="366">Inflammatory arthropathy</strong>
<ul data-end="569" data-start="399">
<li data-end="459" data-start="399" data-section-id="ovk6mv">e.g., rheumatoid arthritis, gout, seronegative arthritis</li>
<li data-end="518" data-start="462" data-section-id="qth9k8">Can present with joint effusion, pain, and stiffness</li>
<li data-end="569" data-start="521" data-section-id="1lup9um">Usually has systemic or multi-joint features</li>
</ul>
</li>
<li data-end="768" data-start="571" data-section-id="1j86csz"><strong data-end="604" data-start="573">Osteoarthritis of the ankle</strong>
<ul data-end="768" data-start="609">
<li data-end="643" data-start="609" data-section-id="1dbszlo">Chronic degenerative condition</li>
<li data-end="698" data-start="646" data-section-id="1gdbs4t">Pain worsens with activity, stiffness after rest</li>
<li data-end="768" data-start="701" data-section-id="11ni2dc">Less likely in younger athletic populations unless prior injury</li>
</ul>
</li>
<li data-end="956" data-start="770" data-section-id="1nvaam5"><strong data-end="814" data-start="772">Syndesmotic injury (high ankle sprain)</strong>
<ul data-end="956" data-start="819">
<li data-end="871" data-start="819" data-section-id="ee3yko">Pain above the ankle joint (distal tibia/fibula)</li>
<li data-end="923" data-start="874" data-section-id="l3o8qw">Worse with dorsiflexion and external rotation</li>
<li data-end="956" data-start="926" data-section-id="1do1s1i">Often from twisting injury</li>
</ul>
</li>
<li data-end="1105" data-start="958" data-section-id="1q8b644"><strong data-end="991" data-start="960">Bimalleolar stress fracture</strong>
<ul data-end="1105" data-start="996">
<li data-end="1047" data-start="996" data-section-id="1h4rqdc">Involvement of both medial and lateral malleoli</li>
<li data-end="1105" data-start="1050" data-section-id="2u1iim">Suggests more advanced or severe bone stress injury</li>
</ul>
</li>
</ul>

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 3

Topic Ankle

Keywords

distal tibial stress fracture

medial malleolus pain

runner overuse injury

ankle effusion

MRI gold standard diagnosis

negative x-ray stress fracture

point-of-care ultrasound Doppler periosteal hyperemia

tibiotalar and subtalar effusions

return-to-run protocol rehabilitation

RED-S metabolic nutritional risk assessment

4th Edition

4th Edition, Case 3

Ankle