Your post is very informative. The information in the case study is insufficient to make a definitive diagnosis. As you discuss in your post, obtaining a CT scan, an X-ray, or other tests might help determine the exact cause of the ankle pain.
I do not favor an ankle fracture in this case, even though it is still possible to bear weight on the extremity with a fracture. The patient presented days later with the pain. In a fracture, the pain is felt right away, and the pain is usually sharp. Patients usually present with a deformity (Lampridis et al., 2018). Other significant symptoms include swelling, blisters, bruising after the break, and a change in ankle appearance (Asymmetry) compared to the opposite side.
Ankle fractures
are often defined as uni malleolar, bimalleolar, or trimalleolar. Referring to the Ottawa Ankle Rule, an inability to bear four steps immediately after an injury and pain in the malleolar zone may signify an ankle fracture (Delahunt et al., 2018).
I firmly believe that the patient is experiencing an ankle sprain. One of the most common ankle sprains is a lateral ankle sprain sustained during sport. An ankle sprain is more common in athletics. Physical examination includes swelling and. ecchymosis, tenderness on palpation, inversion, or eversion. One of the characteristics to assess for ankle sprain is the mechanism of injury, such as a rapid inversion and internal rotation loading to the foot and ankle complex (Delahunt et al., 2019).
Chen, E. T., Borg-Stein, J., & McInnis, K. C. (2019). Ankle Sprains: Evaluation, Rehabilitation, and Prevention.
Current sports medicine reports
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18
(6), 217–
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https://doi.org/10.1249/JSR.0000000000000603
Delahunt, E., Bleakley, C. M., Bossard, D. S., Caulfield, B. M., Docherty, C. L., Doherty, C., Fourchet, F., Fong, D. T., Hertel, J., Hiller, C. E., Kaminski, T. W., McKeon, P. O., Refshauge, K. M., Remus, A., Verhagen, E., Vicenzino, B. T., Wikstrom, E. A., & Gribble, P. A. (2018). Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium.
British journal of sports medicine
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52
(20), 1304–
1310.
https://doi.org/10.1136/bjsports-2017-098885
Lampridis, V., Gougoulias, N., & Sakellariou, A. (2018). Stability in ankle fractures: diagnosis and treatment.
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