The Case:

A 43-year-old otherwise healthy man presented to the ED with ankle pain and swelling. Patient was playing basketball 5 days ago and twisted his left ankle. He initially presented to an outside hospital where he was told he had an “ankle” fracture and was splinted with a short leg posterior splint. He presented to our ED for worsening pain and swelling of his lower leg. On exam, the patient has ecchymosis and edema of the ankle extending proximally just inferior to the knee. There was pain with tibio-fibular compression and point tenderness was present over the medial malleolus and proximal fibula with overlying ecchymosis. The compartments were soft and the leg was neurovascularly intact. The patient was sent for radiographs.

Maria Gomez, MD