Ankle pain

Background

Ankle anatomy: left ankle, anterior-lateral view.

Ankle anatomy: left ankle, anterior-medial view.

Ankle anatomy

Clinical Features

• Ankle pain

Differential Diagnosis

Other Ankle Injuries

• Ankle sprain
• Ankle dislocation
• Ankle syndesmosis injury
• Radiograph-negative ankle injury (peds)

Distal Leg Fracture Types

• Tibial plateau fracture
• Tibial shaft fracture
• Pilon fracture
• Maisonneuve fracture
• Tibia fracture (peds)
• Ankle fracture
  • Ankle fracture (peds)
    • Tillaux fracture
• Foot and toe fractures

Foot and Toe Fracture Types

Hindfoot

• Talus fracture
• Calcaneus fracture

Midfoot

• Lisfranc injury
• Navicular fracture
• Cuboid fracture
• Cuneiform fracture

Forefoot

• Fifth metatarsal fracture
• Non-fifth metatarsal fracture
• Toe fracture

Foot diagnoses

Acute

• Foot and toe fractures
• Subtalar dislocation
• Metatarsophalangeal joint sprain (turf toe)
• Acute arterial ischemia
• Calcaneal bursitis

Subacute/Chronic

• Diabetic foot infection
• Peripheral artery disease
• Plantar fasciitis
• Trench foot
• Ingrown toenail
• Paronychia
• Tinea pedis
• Morton's neuroma
• Diabetic neuropathy

Evaluation

Workup

Acute traumatic

• Consider x-rays
  • Use Ottawa Ankle Rules for acute ankle injuries to determine need for x-rays

Atraumatic / Subacute

• Consider x-rays
• Consider labs for infectious workup (i.e. septic joint)
  • CBC
  • Chemistry
  • Coags
  • ESR/CRP
• Consider arthrocentesis

Diagnosis

Acute traumatic

• Typically determined by imaging

Management

• Posterior Ankle Splint
• Ortho referral for fractures/dislocations

See Also

• Diagnoses by Body Part (Main)