Diagnosis and Treatment of Ankle Pain
Ankle pain can result from a variety of underlying causes, including trauma, arthritis, sports-related conditions, infection, systemic disorders, and neoplastic processes. Successful treatment requires a full understanding of ankle anatomy, a proper history, and a thorough physical examination to yield an appropriate differential diagnosis.
Acute sprains of the lateral ligaments about the ankle are the most common injury in sports and also occur commonly in the general population. Most commonly a partial tear or complete rupture of the ATFL occurs.
More severe injuries include the CFL.
Lateral ankle sprain results from an inversion mechanism.
Classification of Ankle Sprains:
Grade I: Partial tear of the ligaments
Grade II: Partial to complete tear of the ATFL, partial tear of the CFL
Grade III: Complete rupture of the ATFL and CFL
Ankle sprains or low-grade trauma can be treated with the RICE protocol and gradual weight bearing as tolerated.
Patients with ankle fractures should be splinted, instructed to remain non-weight bearing, and referred to an orthopaedist for definitive care.
Hot, swollen, erythematous ankles may warrant arthrocentesis to rule out a gouty attack or septic arthritis.
May be indicated in certain cases once diagnosis and specific treatments are performed such as ROM, strengthening exercises, and proprioceptive retraining if indicated
Patients should show full strength and ROM before returning to sports.
Functional bracing or taping during return to athletics may help prevent recurrence.
FAQ about Ankle Sprains
Q: Which ligaments are involved and in what sequence in a lateral ankle sprain?
A: A lateral ankle sprain injures the following, in order: anterolateral joint capsule, ATFL, and occasionally the CFL.
Q: What are appropriate initial treatments for acute ankle sprain?
A: RICE protocol, stirrup brace, early ambulation, and ROM exercises.
Q: What are 7 possible causes of ankle pain?
A: Fracture, sprain, tendon injury, tendinitis, arthritis, infection, or neoplasm.
Q: What type of condition is suggested by morning stiffness and ankle pain?
A: Rheumatoid or inflammatory arthritis.
Q: What conditions likely require referral to an orthopaedist?
A: Acute fracture, neoplasm, and a chronic condition unresponsive to initial nonsurgical