Differential Diagnosis for a 7-year-old female with sudden sharp pain in the medial left ankle
- Single most likely diagnosis:
- Medial ankle sprain: This is the most likely diagnosis given the sudden onset of sharp pain in the medial ankle, worsened by running and walking, but still present at rest. The lack of discoloration and swelling suggests a mild sprain.
- Other Likely diagnoses:
- Growing pains: Although growing pains are typically bilateral and occur in the legs, they can sometimes be unilateral and localized to the ankle.
- Overuse injury (e.g., medial ankle stress syndrome): Repetitive stress on the ankle from running or other activities can cause pain and inflammation in the medial ankle.
- Ankle tendonitis (e.g., posterior tibialis tendonitis): Inflammation of the tendons surrounding the ankle can cause pain, especially with activity.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Osteomyelitis: Although rare, osteomyelitis (bone infection) can cause severe pain, especially at night, and can be life-threatening if not treated promptly.
- Septic arthritis: Bacterial infection of the joint can cause severe pain, swelling, and redness, and requires urgent medical attention.
- Fracture (e.g., stress fracture or avulsion fracture): A fracture can cause sudden, severe pain, especially with weight-bearing activities.
- Rare diagnoses:
- Tumor (e.g., osteoid osteoma or Ewing's sarcoma): Although rare, bone tumors can cause persistent pain, especially at night, and should be considered in the differential diagnosis.
- Inflammatory conditions (e.g., juvenile idiopathic arthritis): Chronic inflammatory conditions can cause joint pain, swelling, and stiffness, and may require specialized medical attention.