Ankle Pain Discussion Responses
Discussion Responses
Hello Olugemo, I have gone through your post on ankle pain concerning your case study of F. F., a 46-year-old female who presented with bilateral ankle pains and here are responses. You explored the ankle pain very well in your history but don’t you think knowing if the pain is radiating, its relieving factors and the timing (if it is constant or intermittent) would have been an important part of your pain history. Still in your history it would be of significance to rule out history of complicating conditions of ankle injury such as diabetes, arthritis and connective tissue disorders.
Your evaluation of the patient in terms of physical assessment was well done as it confirmed that the right ankle was severely injured compared to the left. The presence of ecchymosis and a higher pain grading scale on the right all support this. The ankle is prone to injury because of its complexity. The injuries range from ankle ligament injuries to fractures to fracture subluxation and dislocation. Grade I and II ankle injuries cause stretching or microscopic tears of the stabilizing ligaments while Grade III ankle sprain may interfere with syndesmotic structures. Moreover, the highest energy incidents may disrupt the tendons and cause fractures. With ankle sprain the most commonly involved structure is anterior talofibular ligament and or calcaneofibular ligament (Melanson & Shuman, 2020).
Information about the diagnostic tests such as the need for X-ray and specific evaluations for ankle injury were well captured. In addition, it would have been necessary to do a Kleiger test to rule out injury to the deltoid ligament (Larkins, Baker & Baker J., 2020) and inversion stress maneuver to assess the integrity of calcaneofibular ligament. Am also in agreement with your assessment differential diagnosis as F.F is likely to have bilateral lateral ankle sprains based on her presentation, Further, it appears that her ankles were forcefully rolled out of their normal position during the exercise, hence stretching them. Generally, your diagnostic formulation was fine all the way from history to differential diagnosis. Thank you.
References.
- Larkins, L. W., Baker, R. T., & Baker, J. G. (2020). Physical examination of the ankle: A review of the original orthopedic special test description and scientific validity of common tests for ankle examination. Archives of Rehabilitation Research and Clinical Translation, 2(3), 100072. https://doi.org/10.1016/j.arrct.2020.100072
- Melanson, S. W., & Shuman, V. L. (2020). Acute ankle sprain. In StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459212/