NURS 6512 ASSESSING MUSCULOSKELETAL PAIN

This is an insightful and revealing post. Patient assessment was important in establishing the reasons for pain and other possible underlying conditions to facilitate the identification of an effective treatment plan. The other differential diagnosis I would recommend is anterior impingement. This condition characterizes strapped structures at the anterior margin of the tibiotalar joint. It usually manifests with ankle pain and limited movement (Vega & Dalmau-Pastor, 2022). The condition is also associated with significant osseous and soft tissue abnormities. Of these differential diagnoses, I would suggest that lateral ankle sprain is the primary diagnosis in this patient. This condition occurs mainly with the inversion of the ankle and involves the lateral ligamentous complex, which entails the anterior talofibular ligament, and calcaneofibular and posterior talofibular ligament that is damaged in reducing order (Lysdal et al., 2022). People with this condition usually suffer tenderness above the sprained ligament, soft tissue swelling, hematoma, and limited range of motion. These features are consistent with the patient in this case. The “pop” sound is a clear sign of a ligament tear.   

References 

Lysdal, F. G., Wang, Y., Delahunt, E., Gehring, D., Kosik, K. B., Krosshaug, T., … & Fong, D. T. (2022). What have we learnt from quantitative case reports of acute lateral ankle sprains injuries and episodes of ‘giving-way’of the ankle joint, and what shall we further investigate? Sports Biomechanics, 21(4), 359-379. https://doi.org/10.1080/14763141.2022.2035801 

Vega, J., & Dalmau-Pastor, M. (2022). Anterior Ankle Impingement and Ankle Instability. In Foot and Ankle Disorders: A Comprehensive Approach in Pediatric and Adult Populations (pp. 1045-1064). Cham: Springer International Publishing. DOI: 10.1007/978-3-030-95738-4_47