Rearfoot / Ankle · Sports Medicine · Medicine & Peri-op · Standard
Stubborn Sprain
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 still hurts."
34-year-old man seen in the outpatient podiatric clinic.
History of present illness
Presents with left ankle pain and swelling that has not settled since he sprained the ankle while running about 2 months ago.
- Pain on weight bearing, walking and palpation, progressively worse over recent weeks
- Persistent swelling of the foot and ankle
- No subsequent trauma
- No fever, chills, redness or drainage
- Deep, achy joint pain with occasional catching; no true locking
- Partial relief with rest and NSAIDs; no formal immobilization or PT yet
Questions a strong candidate asks at this step
- Onset and mechanism of the sprain: inversion vs eversion, plantarflexed vs dorsiflexed, running surface
- Treatment so far: immobilization, bracing, PT, NSAIDs, injections
- Pain character and location (anterior, medial, lateral, deep); night or rest pain
- Mechanical symptoms: catching, locking, clicking, giving way
- Prior ankle sprains or instability
- Weight-bearing tolerance and running/athletic goals
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.