Radiograph-negative ankle injury (peds) - Revision history

ClaireLewis: /* References */

2019-10-06T20:07:32Z

References

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	[[Category:Radiology]]		[[Category:Radiology]]
	[[Category:Pediatrics]]		[[Category:Pediatrics]]
			[[Category:Orthopedics]]

Mholtz at 02:53, 23 February 2017

2017-02-23T02:53:06Z

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	==Disposition==		==Disposition==
	*~~Outpatient~~		*Discharge with PCP follow-up
	**Follow up ~~with primary medical doctor~~

	==See Also==		==See Also==
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	==References==		==References==
	<references/>		<references/>

			[[Category:Radiology]]
			[[Category:Pediatrics]]

Rossdonaldson1: /* See Also */

2017-02-17T17:28:47Z

Rossdonaldson1: /* Disposition */

2017-02-17T17:27:04Z

Disposition

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	==Disposition==		==Disposition==
	*Outpatient		*Outpatient
			**Follow up with primary medical doctor

	==See Also==		==See Also==

Rossdonaldson1: /* Management */

2017-02-17T17:26:47Z

Management

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	==Management==		==Management==
			*Removable ankle brace
			*Return to activities as tolerated by pain

			===Patients do NOT need===
			*Full immobilization (cast or non-removable splint)
			*Referral to orthopedics
			*Repeat x-ray films (or MRI)

	==Disposition==		==Disposition==

Rossdonaldson1: /* Background */

2017-02-17T17:20:50Z

Background

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	**This was commonly treated with immobilization (casting), follow-up imaging, and orthopedic referral (as opposed to adult [[ankle sprain]])		**This was commonly treated with immobilization (casting), follow-up imaging, and orthopedic referral (as opposed to adult [[ankle sprain]])
	*Recent studies have questioned the need for this practice<ref name="Injury MRI Ankle">6. Boutis K, Narayanan UG, Dong FF, et al. Magnetic resonance imaging of clinically suspected Salter-Harris I fracture of the distal fibula. Injury. 2010;41(8):852-856.</ref><ref name="JAMA RN Ankle Study">Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016; 170(1):e154114-e154114.</ref>		*Recent studies have questioned the need for this practice<ref name="Injury MRI Ankle">6. Boutis K, Narayanan UG, Dong FF, et al. Magnetic resonance imaging of clinically suspected Salter-Harris I fracture of the distal fibula. Injury. 2010;41(8):852-856.</ref><ref name="JAMA RN Ankle Study">Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016; 170(1):e154114-e154114.</ref>
	**There was no measurable difference in functional recovery for children with or without [[Salter Harris]] Type 1 distal fibula ~~injuries~~ at 1 and 3 months		**There was no measurable difference in functional recovery for children with or without [[Salter Harris]] Type 1 distal fibula fractures at 1 and 3 months<ref name="JAMA RN Ankle Study">Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016; 170(1):e154114-e154114.</ref>

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Background */

2017-02-17T17:20:09Z

Background

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	**This was commonly treated with immobilization (casting), follow-up imaging, and orthopedic referral (as opposed to adult [[ankle sprain]])		**This was commonly treated with immobilization (casting), follow-up imaging, and orthopedic referral (as opposed to adult [[ankle sprain]])
	*Recent studies have questioned the need for this practice<ref name="Injury MRI Ankle">6. Boutis K, Narayanan UG, Dong FF, et al. Magnetic resonance imaging of clinically suspected Salter-Harris I fracture of the distal fibula. Injury. 2010;41(8):852-856.</ref><ref name="JAMA RN Ankle Study">Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016; 170(1):e154114-e154114.</ref>		*Recent studies have questioned the need for this practice<ref name="Injury MRI Ankle">6. Boutis K, Narayanan UG, Dong FF, et al. Magnetic resonance imaging of clinically suspected Salter-Harris I fracture of the distal fibula. Injury. 2010;41(8):852-856.</ref><ref name="JAMA RN Ankle Study">Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016; 170(1):e154114-e154114.</ref>
			**There was no measurable difference in functional recovery for children with or without [[Salter Harris]] Type 1 distal fibula injuries at 1 and 3 months

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Clinical Features */

2017-02-17T17:18:02Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
	*Lateral ankle pain after inversion injury in a pediatric patient		*Lateral ankle pain (tenderness and/or swelling) after inversion injury in a pediatric patient
	**Studies to date have not addressed medial ankle pain		**Studies to date have not addressed medial ankle pain

Rossdonaldson1 at 17:16, 17 February 2017

2017-02-17T17:16:36Z

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	==Evaluation==		==Evaluation==
	*Consider ankle x-rays		*Consider ankle x-rays

			{{Ottawa Ankle Rules}}

			{{Ottawa Foot Rules}}

	==Management==		==Management==

Rossdonaldson1: /* Clinical Features */

2017-02-17T17:05:34Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
	*Lateral ankle pain after inversion injury		*Lateral ankle pain after inversion injury in a pediatric patient
			**Studies to date have not addressed medial ankle pain

	==Differential Diagnosis==		==Differential Diagnosis==

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	==See Also==		==See Also==
	*[[Salter-Harris fractures]]		*[[Salter-Harris fractures]]
	*[[Ankle diagnoses]		*[[Ankle diagnoses]]
	*[[Ankle fracture]]		*[[Ankle fracture]]
			*[[Ankle fracture (peds)]]

	==External Links==		==External Links==