Potential differential diagnoses for ankle pain:

Achilles tendon rupture, Achilles tendon strain, lateral ligament sprain, fracture, gout, dislocation.

Various types of ankle pain:

Ankle pain may be acute or chronic. Pain may be attributed to various differential diagnoses.

The treatment for ankle pain is largely the same. Patient should be encouraged to “protect” the joint. This may be encouraged by wearing a brace around the affected joint. “Rest” the joint by non-weight bearing, using crutches during ambulation. Applying ice to the affected area. Compressing the surrounding tissues with an ace wrap. Elevating the joint to reduce inflammation. Lastly, using oral NSAIDs for pain control.

Ankle Sprain:

Lateral ligament injuries are the most commonly reported injury to the ankle (Van Rijn et al, 2011). Lateral ligament injuries are the most common injury due to the anatomy of the ankle. The lateral ligament is the most vulnerable ligament.

Sprains are treated in phases.

1 – Protection, Rest, Ice, Compression, Elevation & NSAIDs.

2 – Introduce gentle weight bearing

Various types of treatment

Ice, compression, and elevation.

Depending on the severity of injury immobilization or surgical repair may be indicated.


The mechanism of injury leading to the ankle pain is important to formulating an accurate differential diagnosis. Imaging may be required to narrow down a diagnosis. Imaging such as CT, MRI, and x-ray may be helpful.

Ankle Fractures

Risk factors which predispose patients to a higher risk of ankle fractures include: osteoporosis, diabetes, and obesity (Strauss et al, 2011).

Generally, patients with ankle fractures present with pain, swelling, deformity, and an inability to bear weight on the affected joint (Strauss et al, 2011).  Supination-external rotation fractures are the most common type of ankle fracture (Strauss et al, 2011).

Unimalleolar – involving one side of the ankle

Bimalleolar – involving medial and lateral malleolus

Trimalleolar – Involving three areas of the malleolous.


Treatment of an ankle fracture is contingent upon several factors “A patient is treated nonoperatively if he/she sustains a nondisplaced, stable fracture with an intact syndesmosis or if stable anatomic reduction is achieved after a displaced fracture. ORIF is indicated in open and/or unstable fractures, and when closed reduction fails. Unstable fractures may cause widening of the mortise or displacement of the talus. The method of stabilization utilized during ORIF depends on the anatomical location of the ankle fracture and associated soft tissue injury” (Urruela et al, 2011)

Strauss, E. J., M.D., & Egol, K. A., M.D. (2011). Identifying and managing ankle fractures in older patients. The Journal of Musculoskeletal Medicine, 28(4), 137-140,145-147. Retrieved from https://prx-herzing.lirn.net/login?url=https://search.proquest.com/docview/863651469?accountid=167104

Urruela, A., & Egol, K. (2011). Foot and ankle fractures in the elderly patient. Aging Health, 7(4), 591-605. doi:http://dx.doi.org/10.2217/ahe.11.45

van Rijn, R.,M., Willemsen, S. P., Verhagen, A. P., Koes, B. W., Bierma-Zeinstra, S., & Hush, J. M. (2011). Explanatory variables for adult patients’ self-reported recovery after acute lateral ankle Sprain/Invited commentary. Physical Therapy, 91(1), 77-84. Retrieved from https://prx-herzing.lirn.net/login?url=https://search.proquest.com/docview/846755272?accountid=167104 (Links to an external site.)Links to an external site.

Reply to Dee


Patients can have ankle pain for a variety of reasons. To formulate an accurate diagnosis and differentials, providers must be able to accurately assess physically and with assessment questions. Assessing when the pain started, exacerbating and alleviating factors, and any possible precipitating injuries. An ankle sprain, for example, is caused by sudden stress on one or more of the ligaments of the ankle (Uphold & Graham, 2013). Assessing if the patient twisted the ankle and experienced pain immediately or within the hour of the insult, an inversion injury should be suspected (Uphold & Graham, 2013). Asking the patient exactly how the injury occurred, the positioning of the foot when the injury occurred, if there was any swelling, to describe the type of pain, if ADL’s are affected, if there is any limping or night pain can aid in formulating an accurate diagnosis and treatment plan (Dains, Baumann, & Scheibel, 2016).

Physical assessment should include observing the patient’s gait for any limp, assessing for any deformities, inspection of the skin and nails (for inflammation or the possibility of ingrown toenails causing gait abnormality) (Dains, Baumann, & Scheibel, 2016); measuring limb circumference and length to assess for atrophy and to ascertain if this is a chronic or acute problem; palpation of the joints and performing range of motion is also important in formulation of the diagnosis and treatment.

Performing the anterior drawer test, to assess the anterior talofibular ligaments of the lateral side of the ankle; the talar tilt test to assess the stability of the calcaneofibular ligament; and the squeeze test to assess if medial or lateral damage has occurred (Uphold & Graham, 2013). Differentials include muscle strain, tendonitis, peroneal tendon dislocation, tendon rupture, fracture, gout or arthritis (Uphold & Graham, 2013). Diagnostics that should be included are xray, if there is pain near the malleoli, inability to bear weight, bone tenderness, according to Ottawa rules (Uphold & Graham, 2013). CBC can be obtained to rule out infection, uric acid to rule out gout, RA, ANA and CRP to rule out rheumatoid arthritis, arthritis, and infection, respectively (Dains, Baumann, & Scheibel, 2016).

Treatment is dependent upon diagnosis. If patient has a strain/sprain, rest, ice, compression, and elevation is the appropriate treatment. Patient can also be treated with short term NSAID’s for pain relief. If there is no improvement within 2-3 weeks, or if symptoms worsen, patient may need to be referred to an orthopedist (Uphold & Graham, 2013).


Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced Health Assessment and Clinical Diagnosis in Primary Care (5th ed.). St. Louis, MO: Elsevier.

Uphold, C. R., & Graham, M. V. (2013). Clinical Guidelines in Family Practice (5th ed.). Gainesville, FL: Barmarrae

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

In the dynamic world we currently live in, it’s becoming increasingly difficult for students to balance academics, co-curricular activities and entertainment among others. Students are required to submit countless assignments in a short time frame. These assignments should not be taken lightly as they form a major part of the grade when it comes to the end of the semester. Understanding the value of education and how these grades are important to students, Infinite Essays has made it its mission in life to offer customized essays to students at an affordable cost.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

There are plenty of reasons why you should order a paper with Infinite Essays. We have reliable writers who are also very competent. They have over the years managed to work under tight schedules and deadlines. Whenever you order an essay with Infinite Essays, you are guaranteed a fast turnaround of your project and this is done on time. Other than writing custom papers, our writers provide value added services that include academic assistance in the areas that they have specialized in. We ensure that the work that we offer is free of plagiarism. Infinite Essays does not condone plagiarism in whatsoever manner. Our writers are very experienced and can handle of sorts of formats such as Turabian, Chicago, Harvard as well as APA and MLA. Infinite Essays covers a wide range of topics. At the moment, we specialize with over 68 topics. We understand the importance of maintaining confidentiality when dealing with our clients. It’s for this reason that we will never reveal the identity of our clients to whoever may be interested. Finally, we offer the most competitive rates in the industry.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Whenever you want to make an order with us, you will use our automated online ordering system. If you are having some difficulties of any sort, feel free to contact our live support and they will be more than happy to assist you. Ensure that you fill all the relevant information regarding your order. This is the area where you have to include the deadline of your assignment, the formatting style to be used and even the kind of academic paper you desire. The more information you give to our writers, the better.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Brief explanations of how our services work 1. Provide us with the necessary instructions. Go to the Order Now page and click the order now button. This is the part where you have to attach all the relevant attachments. At the same time, remember to add the instructions sheet here. Once you are sure that you have submitted all relevant information, please submit the final draft to us. 2. The second step will involve paying for the services. This is where an invoice will be sent to you. However, the easiest process is clicking the payment link and following all the prompts that come along. At the moment, all payments are made through PayPal only. 3. Working on your paper. Once you have made the payment, we will assign the order to a writer who will follow the instructions. Remember that our writers will spend countless hour laboring to ensure that the work they provide is meticulously researched. 4. Download your paper. When the writer is finished with the assignment, they will submit it to our writers who will then go through the paper to ensure that the paper has followed all instructions and there are no grammatical errors. We will then forward a copy of the assignment to your email. 5. Tell your friends. We always happy to receive a referral. Whenever a friend tells us that you recommended our services to them, we will give you a 40 percent discount for your next order. Whenever you have provided us with the necessary details, we will forward them to qualified writers who will handle the assignment for you. Remember that the writers will begin working on the assignment immediately. This is the sole reason we encourage our clients to provide their exact specifications during the first time.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Tackling an order may be challenging but we always offer the best. Before the assignment can be passed to you by our writers, it will be passed through a team of qualified editors and proofreaders to ensure that the paper is accurate and of the required quality. Once the editors are satisfied with the assignment, they will forward the assignment to your account and a copy to your email.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Discounts We offer the best prices in the industry. We currently have a 20 percent discount for all of our customers. If you feel the budget is putting a strain on you, contact our live support and they might consider you case. We treat each case differently. Remember that our main goal is to continue with education transformation. At the moment, we only accept payments in form of PayPal.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Why Choose Us While there are many companies in the writing service industry claiming to offer platinum services, none can match the services offered by Infinite Essays. Some of our writers have been with us since 2010. The testimonials that have been written by some of our happy customers is an indication of the good services that we offer.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline