Author: William McCafferty, DO
Co Author #1: Jarem Lloyd, Md
Co Author #2: Gobindveer Singh Sahi, MD
Co Author #3: Maheep P. Vikram, MD
Editor: Shawn Phillips, MD, MSPT
Senior Editor: Christian Fulmer, DO
A 19-year-old female junior college volleyball player presented with right ankle pain over the preceding 48 hours. One day prior to the onset of her current symptoms, she had been playing volleyball and developed an acute exacerbation of right ankle pain, although she denied any specific injury to the right ankle or foot during her game. The patient reported that she has had intermittent right ankle pain for over five years. Her only known injury was a sprain to the affected ankle approximately 8 years ago. At presentation her symptoms included pain, swelling, and warmth, but no erythema. Her pain was worse at nighttime and at rest. She reported feeling generally unwell over the previous 48 hours but denied any specific fever, chills, rigors, nausea, vomiting, weight loss, or infectious process.
Ipsilateral Ankle Sprain 8 years prior
On exam vital signs were within normal limits. The right ankle had generalized swelling and diffuse tenderness. It was warm but there was no erythema or evidence of cellulitis or abscess. There was no significant focal bony tenderness. Her range of motion was limited in all planes secondary to pain and swelling. Pedal pulses and distal neurological exam were normal. Remainder of the physical exam was unremarkable.
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