Ankle Injury

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History of Present Illness:

• A 32-year-old female presents to the ED for an ankle injury
• She denies fever or other complaints

Vital Signs & Physical Exam:

• Vital signs are normal.
• Physical exam is normal except for lateral ankle tenderness and mild swelling.  There is no knee of foot tenderness

Initial Differential Diagnosis:

• Sprain
• Fracture

Initial Diagnostic Testing:

• Ankle x-ray

QUESTIONS:

1. What does the case image show?  
2. What should you do next?  
3. Want a 1-minute consult/tutorial on this case? 
4. Want to know what happened with this patient?

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ANSWERS:

1. What does the case image image show?  NO FRACTURE BUT AN ANKLE EFFUSION
2. What should you do next?  Treat as a sprain
3. Want a 1-minute consult/tutorial on this case?  See yellow area from sample page below.
4. Want to know what happened with this patient?  See case conclusion below tutorial page.

1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

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CASE CONCLUSION: No fracture.  Healed well after 2 months total

Here’s an article on ankle effusions: https://pubs.rsna.org/doi/abs/10.1148/radiol.2313021096?journalCode=radiology