Ankle - Patient Case Questions Flashcards
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Lateral ankle sprain:
- The symptoms are indicative of an injury to the lateral ligaments, common with inversion injuries.
What am I = ?
A 25-year-old female reports to the clinic with recurrent episodes of her ankle “giving way” while playing basketball. She has a history of repeated ankle sprains. Which condition is most likely?
Chronic Ankle Instability (CAI):
- Characterized by recurrent sprains and instability, commonly due to a history of such injuries.
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During a physical examination, which test is most appropriate for diagnosing a suspected syndesmotic ankle sprain in a 30-year-old rugby player who experienced a high-impact twist to his ankle?
Syndesmotic squeeze test: Specific for assessing syndesmotic injuries, common in sports that involve high-impact or twisting actions.
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A 22-year-old dancer presents with pain and restriction during dorsiflexion of her ankle. Which condition is most likely based on the pain pattern and her profession?
Anterior ankle impingement: Common in dancers due to repetitive stress and hyperextension, presenting with pain during dorsiflexion.
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Which test would be most indicative of a lateral ankle sprain in a 19-year-old basketball player who landed awkwardly on another player’s foot?
Anterior Drawer test: Used to assess the integrity of the anterior talofibular ligament, commonly injured during basketball activities.
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What is the most likely diagnosis for a 20-year-old male soccer player who reports acute pain over the anterior lateral ankle with a popping sound after an inversion injury during a game?
- A) Achilles tendon rupture
- B) Lateral ankle sprain
- C) Ankle fracture
- D) Tibialis anterior strain
What is the most likely diagnosis for a 20-year-old male soccer player who reports acute pain over the anterior lateral ankle with a popping sound after an inversion injury during a game?
- A) Achilles tendon rupture
- B) Lateral ankle sprain
- C) Ankle fracture
- D) Tibialis anterior strain
Rationale:
- The reported symptoms of acute pain and a popping sound following an inversion injury are typical of a lateral ankle sprain.
- An inversion injury commonly affects the lateral ligaments, particularly the anterior talofibular ligament, which aligns with the mechanism of injury (MOI) described.
What am I = ?
A 25-year-old female reports to the clinic with recurrent episodes of her ankle “giving way” while playing basketball. She has a history of repeated ankle sprains. Which condition is most likely?
- A) Chronic Ankle Instability (CAI)
- B) Syndesmotic ankle sprain
- C) Cuboid syndrome
- D) Peroneal tendinopathy
A 25-year-old female reports to the clinic with recurrent episodes of her ankle “giving way” while playing basketball. She has a history of repeated ankle sprains. Which condition is most likely?
- A) Chronic Ankle Instability (CAI)
- B) Syndesmotic ankle sprain
- C) Cuboid syndrome
- D) Peroneal tendinopathy
Rationale:
- Chronic Ankle Instability (CAI) is characterized by recurrent sprains and a sensation of the ankle “giving way.”
- This condition is commonly seen in patients with a history of repeated ankle sprains, leading to weakened ligaments and impaired proprioception, making it the most likely diagnosis given the patient’s history and symptoms.
What am I = ?
During a physical examination, which test is most appropriate for diagnosing a suspected syndesmotic ankle sprain in a 30-year-old rugby player who experienced a high-impact twist to his ankle?
- A) Talar tilt test
- B) Anterior drawer test
- C) Syndesmotic squeeze test
- D) Thompson test
During a physical examination, which test is most appropriate for diagnosing a suspected syndesmotic ankle sprain in a 30-year-old rugby player who experienced a high-impact twist to his ankle?
- A) Talar tilt test
- B) Anterior drawer test
- C) Syndesmotic squeeze test
- D) Thompson test
Rationale:
- The Syndesmotic squeeze test is specific for diagnosing syndesmotic ankle sprains, which typically occur from high-impact or twisting injuries to the ankle.
- This test is relevant for assessing the integrity of the syndesmosis, particularly in athletes like rugby players who are prone to such injuries.
What am I = ?
A 22-year-old dancer presents with pain and restriction during dorsiflexion of the ankle. Which condition is most likely based on the pain pattern and her profession?
- A) Anterior ankle impingement
- B) Lateral ankle sprain
- C) Achilles tendinopathy
- D) Medial malleolus fracture
A 22-year-old dancer presents with pain and restriction during dorsiflexion of the ankle. Which condition is most likely based on the pain pattern and her profession?
- A) Anterior ankle impingement
- B) Lateral ankle sprain
- C) Achilles tendinopathy
- D) Medial malleolus fracture
Rationale:
- Anterior ankle impingement, often seen in dancers, is characterized by pain and restricted motion during dorsiflexion.
- This condition is typically caused by repetitive stress and hyperextension movements found in dance.
Which test would be most indicative of a lateral ankle sprain in a 19-year-old basketball player who landed awkwardly on another player’s foot?
- A) Anterior Drawer test
- B) Lachman test
- C) McMurray test
- D) Valgus stress test
Which test would be most indicative of a lateral ankle sprain in a 19-year-old basketball player who landed awkwardly on another player’s foot?
- A) Anterior Drawer test
- B) Lachman test
- C) McMurray test
- D) Valgus stress test
Rationale:
- The Anterior Drawer test assesses the integrity of the anterior talofibular ligament, which is frequently injured during inversion injuries typical of awkward landings in basketball. A positive test suggests a lateral ankle sprain.
What am I = ?
Brian Smith, a 22-year-old male, presents to the clinic with severe lateral ankle pain following a basketball game where he heard a popping sound. He exhibits significant swelling and bruising with restricted dorsiflexion to 10 degrees and plantarflexion to 20 degrees. He reports pain exacerbated by walking. A positive Talar tilt test indicates significant ligamentous injury.
- Grade III Lateral Ankle Sprain
- Rationale:
- Brian’s presentation with severe lateral ankle pain, a popping sound at the time of injury, significant swelling, bruising, restricted motion, and a positive Talar tilt test suggest a Grade III Lateral Ankle Sprain, indicating a complete ligament tear.
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Emily Johnson, a 30-year-old female, returns to the clinic with complaints of her ankle “giving way” frequently during routine activities. She has a history of multiple ankle sprains and feels instability that is confirmed by a positive Anterior Drawer test. She mentions only mild pain and no recent swelling.
- Chronic Ankle Instability
- Rationale:
- Emily’s history of recurrent ankle sprains, her symptoms of the ankle “giving way” during routine activities, and a positive.
- Anterior Drawer test support the diagnosis of Chronic Ankle Instability. This condition typically presents with mechanical instability and subjective feelings of unsteadiness.
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Mark Thompson, a 25-year-old male athlete, experiences sharp pain and tenderness on the medial side of his ankle, especially during activities that stress the posterior tibial tendon, like heel raises. The palpation of the posterior tibial tendon elicits significant pain, suggesting a localized issue.
- Posterior Tibial Tendon Dysfunction
- Rationale:
- Mark’s symptoms of sharp pain and tenderness localized to the medial side of the ankle, particularly during activities that load the posterior tibial tendon, along with positive palpation results, are consistent with Posterior Tibial Tendon Dysfunction.
- This condition often involves pain and functional impairment related to the tendon’s inability to support the arch.
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Sarah Lee, a 29-year-old female marathon runner, presents with sharp, localized pain in the medial side of her lower leg. She reports the pain intensifies during running and eases with rest. Palpation reveals a 6 cm area of tenderness along the posteromedial border of her tibia.
- Medial Tibial Stress Syndrome
- Rationale:
- Sarah’s symptoms of exercise-induced pain along the posteromedial border of the tibia, which eases with rest, and localized tenderness in a specific area align with Medial Tibial Stress Syndrome, commonly known as shin splints.
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John Carter, a 35-year-old construction worker, complains of chronic heel pain that is worst with the first steps in the morning but also bothers him after long periods of standing. Examination shows a positive Windlass test.
- Plantar Fasciitis
- Rationale:
- John’s symptoms of heel pain that worsens with the first steps in the morning and a positive Windlass test are classic indicators of Plantar Fasciitis.
