Case of the Week 2-25-13: KISS the Ankle
Here is a case for you regular readers, what would you do in this situation?
Subjective: The patient is a mid 30s border patrol agent who has been working out regularly. About two months ago, he slipped, and slightly rolled his right ankle inward. There was no swelling, and he rested for a few weeks. Since then he has been unable to exercise regularly, cut left or right and perform any lunging like activities. He complains of pain in the lateral border of his right talus. At first I thought he was pointing to his sinus tarsi area, but it was his talocrural joint.
FN in MSR, Hip mobility, tibial IR, and his ankle df test could bash his knee right through the wall. This says, not a mobility issue.
SLS and SL Swing tests were also FN.
The patient was FP with ankle pain on the right with DS and SL Squat
I did not check rolling as he was a patient last year for left hip and knee issues, and it was FN then, plus he has been keeping up with that HEP.
No tenderness to touch. All MMT were strong and pain free.
I'll ask you the first thing I asked my current intern who was observing the evaluation. Pop quiz hotshot, what would you look at next? Please, no special test suggestions!