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

Author: Abbie Kelley, DO
Co Author #1: R. Scott Cook, D.O.

Patient Presentation:
Right Ankle Pain

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.

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