La Maison

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La Maison - Page #1

Author: Michael Grasic, MD Co Author #1: Tracey Viola, DO Co Author #2: Daniel Bullock, MD Senior Editor: Christian Fulmer, DO Editor: Amy Valasek, MD, MS, FAMSSM Patient Presentation: 25-year-old female skateboarder presented to the sports medicine clinic 12 days after a left ankle injury. History: She was on a halfpipe during a skateboarding contest, when she performed a trick and landed with her left foot caught under her skateboard. She stated she heard a crack and experienced pain over the medial ankle immediately after. She subsequently felt numbness which radiated from the left proximal shin distally. She presented to the Emergency Department that day as she was unable to bear weight on her left lower extremity. Her ankle was swollen, felt stiff, and weak. She had radiographs taken of her left ankle and was placed in a splint. Due to continued pain, she was subsequently evaluated at an urgent care and a second emergency department prior to the sports medicine clinic. Physical Exam: General: Not in acute distress, non-weight bearing on crutches. Left ankle and leg: Edema and ecchymosis noted from the lateral proximal shin distally toward the medial ankle. The majority of her tenderness was localized around the medial ankle and around the medial malleolus. Mild tenderness was noted over the 3rd metatarsal and mid shaft of the fibula. Presence of mild calf tenderness. Non-tender over lateral malleolus, anterior ankle joint, cuboid, navicular, anterior talofibular ligament, base of 5th metatarsal and remainder of the foot. Limited range of motion of the ankle in all planes. Strength 4-5/5. Pulses 2+ and sensation intact. Right ankle: No gross deformity, nontender throughout, strength 5/5 with full range of motion. Negative anterior drawer. Pulses 2+ and intact. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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