Forefoot / Midfoot · Trauma · Sports Medicine · Standard
Pothole Run
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 sprained my ankle."
33-year-old male seen in your office the same day as the injury.
History of present illness
Was running in the park for exercise earlier today when he stepped into a pothole and his foot rolled under him (inversion with the forefoot adducted and plantarflexed). He had immediate pain in the LEFT foot and ankle, which became swollen and bruised. He called your office and came in several hours later.
- Felt a "pop" on the outside of the ankle; no fall to the ground, no head strike
- Pain 7/10, lateral ankle and outside of the midfoot, worse with weight bearing and with turning the foot in
- Able to take a few painful steps immediately; now limping and avoiding weight on the outside of the foot
- Some tingling along the outside of the foot since the injury
- No open wounds; has iced and elevated, took ibuprofen
- No fever, chills, nausea, vomiting, chest pain or SOB
- Last meal 3 hours ago
Questions a strong candidate asks at this step
- When exactly did it happen? Mechanism and foot position (inversion, plantarflexion, forefoot adduction)?
- Did you fall or hit your head? Any other injuries (knee, hip, back)?
- Hear or feel a pop or snap?
- Where exactly is the pain — can you point to it? Severity, radiation, progression
- Able to bear weight immediately (Ottawa rules)? Able to now?
- Numbness, tingling, burning? Cold or color change?
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.