Rearfoot / Ankle · Reconstructive · Pediatrics · Advanced
Aching 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 left ankle hurts."
18-year-old female seen in your office.
History of present illness
Left ankle pain present for about 1–2 years and getting worse. The pain is dull and throbbing and is aggravated by prolonged standing or activity. It is accompanied by occasional hip and lower back pain on the opposite (right) side. She has tried OTC pain medication as her only treatment.
- Pain 6/10 at the lateral and anterior ankle, relieved by rest
- Notices the ankle 'rolling in' and the arch flattening over the past few years
- No recent injury, swelling episodes, locking or giving way
- No numbness, tingling or night pain
- No fever, chills or weight loss
Questions a strong candidate asks at this step
- Onset, duration, progression; any new or prior injury?
- Location, character, severity, radiation of pain
- Aggravating and relieving factors; start-up pain, night pain
- Swelling, instability, locking, catching
- Change in foot shape, shoe wear, limb length (limp, hip/back pain)
- Neurologic symptoms
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.