A Curious Case Of Ankle Pain - Page #1

Author: Thomas Dagg, MD
Co Author #1: Paul Cleland, MD
Senior Editor: Carolyn Landsberg, MD
Editor: Steven Brown, MD

Patient Presentation:
A 17-year-old female presented to our Sports Medicine clinic four weeks after sustaining an inversion left ankle injury while playing volleyball. After the injury, the patient was evaluated and diagnosed with a grade 2 ankle sprain. Initial treatment included protected weight bearing using a controlled ankle motion walking boot for ten days followed by rehabilitation with the athletic trainer. During this time, the patient was taking over the counter ibuprofen with no relief of pain. At the time of presentation to the clinic, the patient was still experiencing significant swelling, anterior ankle pain that worsened with running and jumping, and popping within the ankle joint.

The patient had no pertinent past medical history and no previous left ankle injuries.

Physical Exam:
Left ankle examination revealed a small effusion, calor without erythema, and decreased dorsiflexion and eversion. The remainder of active and passive range of motion was normal. There was tenderness to palpation at the syndesmosis, anterior talofibular ligament (ATFL), and the calcaneofibular ligament (CFL). No laxity was noted on anterior drawer or talar tilt maneuvers, although both elicited pains. Pain was also noted with eversion stress test, dorsiflexion-external rotation stress test, and syndesmosis squeeze test. Strength was 5/5 in all tested muscle groups.

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NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

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Phone: 913.327.1415

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