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Ankle pain

  • Ddx

    • fracture
    • strain, sprain
    • achilles tendonitis
    • tarsal tunnel syndrome (paresthesia, plantar pain without tenderness)
    • skin issue (contact dermatitis)
  • Ottawa rules. Get an ankle xray if

    • age > 55
    • tenderness of medial or lateral malleolus
    • tenderness of tib/fib posterior edge 6cm above either malleolus
    • unable to ambulate 4 steps
  • Get a foot xray if

    • navicular tenderness
    • 5th metatarsal tenderness
    • unable to ambulate 4 steps
  • Tx for uncomplicated ankle pain

    • RICE (rest, ice, compression, elevation), tylenol
  • HPI

    • onset
    • triggering events: trauma
    • location
    • quality
    • severity, pain at night
    • aggravation: weight bearing
    • alleviation: OTCs, rest
    • ability to ambulate
  • ROS

    • fever
    • rash
    • chest pain, dyspnea
    • nausea, vomiting, diarrhea, abdominal pain
    • numbness, tingling
  • PMH

    • arthritis
  • FH

  • SH

    • running
  • Meds

  • Allergies

  • General Px

    • vitals
    • gen impression
    • cardio, pulm, GI
    • neuro
  • Ankle Px

    • inspection: erythema, pallor, bruising, deformity, open skin wound
    • palpation: medial and lateral malleolus, posterior edge of tib/fib 6cm above either malleolus, navicular, base of 5th metatarsal, achilles
    • check pedal pulse
    • strength and ROM of the ankle and knee
    • sensation of toe
    • check the knee
    • ability to ambulate

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.