Seen in the ED: Ankle Injury

A 32-year-old woman is seen in the ED with pain from an ankle injury sustained about 24 hours earlier. What does the x-ray show? How would you proceed?

Patient history. A 32-year-old woman presents to the emergency department (ED) for an ankle injury that occurred approximately 24 hours ago. She denies any other injury, fever, or other complaints.

Vital signs & physical examination. Vital signs are normal. Physical exam is normal except for lateral ankle tenderness and mild swelling. There is no knee or foot tenderness.

Initial diagnostic testing. Ankle x-ray (below)

What does the x-ray show?

A. Calcaneal fracture

B. Ankle effusion

C. Talar fracture

D. Navicular fracture

Find many more puzzling presentations in Patient Care's collection of Dr Pregerson's "Seen in the ED" cases.

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