Simon's adventures in Podiatryland: Part 5 - A simple ankle sprain?

This is the 5th in my little series of "red flags" I have encountered over the years and this one, I hope, will serve as a warning to us all.

The bottom line here is that if you have that little alarm bell tingling at the back of your mind, you MUST pay attention, and you MUST investigate.

This is Jenny's story

Jenny is a 27-year-old mother of three who loves to play hockey. Jenny presented to me many years ago for treatment of blistering and callus formation over 5th MTH left foot only associated with hockey and her footwear. Biomechanically she has what might best be described as a fully compensated FF valgus, but other than the blistering, she has had few issues.

Then, Jenny suffered an ankle inversion injury to her right foot whilst playing hockey that resulted in rapid swelling but no pain perception, red flag number one!

Her local medical officer ordered plain film Xrays & diagnosed the injury as a Grade 2 sprain, red flag number 2! He then prescribed rest, ice, compression, and elevation, red flag number 3!

The plain film radiographs quite clearly tell another tale:

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Ok, so my tentacles were already twitching on the retelling of this tale, especially given that, five weeks later, there was persistent and florid swelling.

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OK, so what is our next move?

  • blood tests?
  • MRI/CT?

Nope, our next move is to revisit the relevant medical history and to drill down on what is going on here. I am purposely nagging you all about history taking.

Simon Bartold
Director of Bartold Clinical