A healthy 23-year-old woman, who is a longtime runner, calls your office the day after she tripped on a tree root while running in the woods and twisted her right ankle. She noted immediate pain on the lateral side of the ankle but did not hear or feel a pop. She was able to bear weight and walked out of the woods. However, as she walked, the ankle became more painful and began to swell. When she reached home, she applied a heating pad and rested the ankle. The next morning she noted increased swelling and moderate discomfort while walking.
She now is concerned that she will be unable to run. She has no history of past ankle injuries, and she has no known medical problems or allergies.
WHICH TWO OF THE FOLLOWING WOULD YOU DO NOW?
A. Advise the patient to continue to use the heating pad.
B. Tell her to stop using heat and switch to ice.
C. Order a radiograph of the ankle.
D. Have the patient elevate the right leg and compress the ankle with an Ace bandage.
(Answer on next page.)
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in Sport Injury Management. Champaign, Ill: Human Kinetics; 1995:209-215.
2. Stiell IG, McKnight RD, Greenberg GH, et al. Implementation of the Ottawa
ankle rules. JAMA. 1994;271:827-832.