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From Road Miles To The Tennis Court - A Case Of Lateral Foot Injury With Dual Pathogenesis - Page #1
 

Author: Sean Thuesen, DO, MS
Co Author #1: Michael Shaffer, DO
Co Author #2: Christopher John, MD
Co Author #3: Jonathan Stewart, MD
Senior Editor: Drew Duerson, MD
Editor: Stephanie Aldret, DO

Patient Presentation:
A 57-year-old female recreational runner with no significant past medical history presented to an orthopedic clinic with right lateral foot pain.

History:
She initially developed mild lateral foot pain during the summer while training for a half marathon. Although she completed the race, the pain persisted despite subsequent rest. At that time, she denied associated swelling or bruising.

Approximately three months later, while playing tennis, she sustained an inversion injury to her right ankle, resulting in sudden pain and swelling along the lateral plantar aspect of the foot with radiation throughout the lateral foot and ankle.

Prior to orthopedic evaluation, she managed her symptoms with ice, ibuprofen, and crutches to avoid weight-bearing.

Physical Exam:
Evaluation of the right foot and ankle demonstrated intact skin and moderate swelling over the lateral aspect of the foot.

The patient had full range of motion of the foot and ankle without exacerbation of baseline pain. Tenderness to palpation was localized over the lateral cuboid. There was no tenderness over the Lisfranc ligament, fifth metatarsal, or elsewhere in the foot or ankle.

Anterior drawer and inversion stress tests were negative.

Neurovascular examination of the right lower extremity was normal.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

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