Rearfoot / Ankle · Reconstructive · Sports Medicine · Standard
Locking Ankle
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
"My ankle still hurts months after I sprained it."
43-year-old female seen in the podiatry clinic.
History of present illness
Inversion ankle sprain a few months ago treated with an ankle brace. Pain never resolved.
- Continued pain with weight bearing, mainly around the lateral ankle and sinus tarsi
- Foot "locks up" at times, with episodes of peroneal cramping
- Worse on uneven ground and with prolonged standing; rest helps
- History of recurrent ankle sprains since adolescence
- No numbness, tingling or swelling between episodes
Questions a strong candidate asks at this step
- Mechanism and treatment of the original sprain
- Location of pain: ATFL/CFL, sinus tarsi, peroneals, medial
- Mechanical symptoms: locking, catching, giving way
- Recurrent sprains since childhood/adolescence (coalition)
- Treatments tried (brace, PT, injections)
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.