Ankle pain and swelling: Difference between revisions

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   Caption        = Normal ankle; Lateral view|
   Caption        = Normal ankle; Lateral view. <br> [http://www.radswiki.net Image courtesy of RadsWiki]|
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'''Contributors:'''  [[User:zorkun|Cafer Zorkun]] M.D., PhD.
 
 


== Overview ==
== Overview ==
* Common problem that occurs secondary to a chronic or an acute injury or degenerative disease.
* Common problem that occurs secondary to a chronic or an acute injury or degenerative disease.
* Ankle sprains are the most common cause of ankle pain.
* Ankle sprains are the most common cause of ankle pain.
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The content on this page was first contributed by {{CMG}}
The content on this page was first contributed by {{CMG}}


List of contributors:
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== Suggested Reading and Key General References ==
== Suggested Links and Web Resources ==
== For Patients ==


{{SIB}}
[[Category:Musculoskeletal Disease]]
[[Category:Musculoskeletal Disease]]
[[Category:Symptoms]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]


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Latest revision as of 15:58, 1 June 2015

Ankle pain and swelling
Normal ankle; Lateral view.
Image courtesy of RadsWiki

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Contributors: Cafer Zorkun M.D., PhD.


Overview

  • Common problem that occurs secondary to a chronic or an acute injury or degenerative disease.
  • Ankle sprains are the most common cause of ankle pain.
    • Ankle sprain are generally a traumatic inversion injury
  • Bilateral ankle swelling can be indicative of cardiac or vascular etiologies rather than intrinsic foot/ankle disease

Differential Diagnosis

  • Avulsion fracture of the distal fibula
  • Bimalleolar fracture
  • Degenerative joint disease
  • Diabetic arthropathy (Charcot's)
  • Inversion sprain
  • Inversion/eversion injury of subtalar joint
  • Neoplasm
  • Peroneal nerve entrapment
  • Poor shoe alignment
  • Repetitive injury with disruption of the ankle retinaculum
  • Syndesmosis injury
  • Trimalleolar fracture

Physical Examination

  • Complete physical including ankle, foot, lower leg examination
  • Pulses
  • Neurovascular status
  • Color
  • Capillary refill

X-Ray

  • Ottawa ankle rules determine necessity of ankle x-ray following trauma
    1. Tender proximal fifth metatarsal
    2. Tenderness of distal 6 cm of the fibula or tibia
    3. Tender navicular area
    4. Cannot bear weight (at least 4 steps)
  • Lateral x-rays if needed
  • Three-view ankle x-rays
  • Stress views
  • Foot series
  • Lower leg series

Images courtesy of RadsWiki

MRI and CT

  • CT and MRI if indicated

Other Diagnostic Studies

  • Anterior/posterior drawer test
  • Range of motion and muscle strength

Treatment

Mnemonics for treatment of ancle pain and swelling.

  • PRINCE
    • Protection
    • Rest
    • Ice
    • NSAIDs (nonsteriodal anti-inflammatory drugs)
    • Compression
    • Elevation
  • Casting if necessary
  • To improve range of motion and muscle strength, physical therapy is often recommended

Surgery and Device Based Therapy

  • Bracing ankle/foot may prevent reinjury
  • Surgery may be necessary for certain fractures

References

Acknowledgements

The content on this page was first contributed by Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]


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