Recurrent Atraumatic Ankle Pain In An Adolescent Female Athlete - Page #1
 

Author: Abbie Kelley, DO
Co Author #1: R. Scott Cook, D.O.
Editor: Brian Vernau, MD

Patient Presentation:
Right Ankle Pain

History:
14 y.o. multisport female athlete, who presents with right anterior ankle pain over the last 3 years. No discrete injury or trauma. Associated with clicking, stiffness, and swelling. Worse during and after activity and improves with rest, ice, NSAIDS. She most recently completed a cross country season where her pain had worsened, but she was able to run through it. She presented for evaluation when the pain persisted despite rest for 2 months after the season was completed. She has a remote history of ankle sprain but no other injury history. Denies night pain.

Physical Exam:
Patient afebrile with normal vital signs. Non-antalgic gait. Full ankle ROM bilaterally with normal strength other than 4+/5 eversion and mild pain to resisted dorsiflexion on the right. Right ankle with scant effusion to anteromedial joint line with tenderness to palpation of anteromedial talus. No tenderness over malleoli, tibia, fibula. No soft tissue or achilles tenderness. Negative heel tap test. No ligamentous instability or pain with ligament testing. Normal subtalar motion. Distal pulses and sensation intact.

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


NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
 

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415


Website created by the computer geek