Author: Ryan Reese, DO
Co Author #1: Alex Madeira
Editor: Charlie Michaudet, MD
Senior Editor: Charlie Michaudet, MD
Editor: Margaret Gibson, MD
16-year-old male soccer athlete presented to team training room for evaluation of left dorsal foot and lateral ankle pain. He reports that he had his foot stepped on in a soccer game yesterday and in another game 2 days ago. He has noticed some bruising and progressive swelling extending from his ankle to his toes. He can bear weight on his injured foot. Supportive care is initiated. The next day in the training room he reports that his foot is getting significantly worse. He has noticed that the bruising is now extending to his proximal toes and his foot continues to swell.
He has a history of left ankle injuries with the most recent being 2 months ago. He reports that he does bruise easily.
General: He is very tall and lean. No acute distress
MSK: Antalgic gait. Significant edema on dorsal surface of left foot. Ecchymosis noted on dorsal surface of left foot extending to the proximal toes. No point tenderness over 5th metatarsal or lateral malleolus. Some limited dorsiflexion due to pain. Plantar flexion, inversion, eversion normal range of motion. Negative anterior drawer test. Positive talar tilt. Bruising also noted on bilateral shins.
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