Rearfoot / Ankle · Trauma · Medicine & Peri-op · Standard
Kitchen Stool
Podiatric surgery residency interview case. Work through it the way you would at an interview: take the history, ask for the exam and imaging, then commit to a diagnosis and plan.
Chief complaint
"I fell off a stool in my kitchen and my left ankle really hurts."
62-year-old female presenting to the emergency department.
History of present illness
Fell about 1 foot from a kitchen stool earlier today and landed awkwardly, twisting the left ankle. Immediate medial and anterior ankle pain, swelling, and inability to bear weight.
- Low-energy, rotational mechanism (foot planted, body rotated)
- No loss of consciousness, no head strike, no other injuries
- No syncope or chest pain preceding the fall (mechanical fall, not a cardiac event)
- No open wounds, no new numbness or tingling (chronic mild foot numbness from diabetes)
- Closed injury, so tetanus is not a concern; last meal 5 hours ago (relevant if sedation or OR is needed)
- Pain 7/10, throbbing, worse with any motion
Questions a strong candidate asks at this step
- Mechanism: height, direction of force, foot position (rotation vs. axial load)
- Cause of the fall: mechanical vs. syncope, dizziness, chest pain, hypoglycemia
- Time since injury, ability to bear weight, deformity at the scene
- Head strike / LOC / other injuries (primary and secondary survey)
- Open wound, numbness, tingling, cold or pale foot (neurovascular status)
- Prior ankle injury, prior fracture
Present the rest of the case
Past history, exam, imaging, assessment, plan and discussion questions, with model answers, are in the interactive trainer. The diagnosis is kept there on purpose so you can practice committing to one.