Differential Diagnosis for Sharp Pain Left Lateral Ankle/Foot

Single Most Likely Diagnosis

• Ankle Sprain: This is the most common cause of sharp pain in the lateral ankle, often resulting from inversion injuries that stretch or tear the ligaments on the outside of the ankle. The sharp pain is typically accompanied by swelling, bruising, and difficulty walking.

Other Likely Diagnoses

• Peroneal Tendinitis: Inflammation of the peroneal tendons, which run along the lateral aspect of the ankle, can cause sharp pain, especially with activities that involve ankle movement. This condition is common in individuals who participate in sports that involve repetitive ankle motion.
• Lateral Ankle Impingement: This condition occurs when there is compression of the soft tissues (such as ligaments, tendons, or joint capsule) between the bones of the ankle joint, leading to sharp pain on the lateral side, especially with dorsiflexion.
• Stress Fracture: A small crack in one of the bones in the foot or ankle, often caused by overuse or repetitive stress, can lead to sharp pain that worsens with activity and improves with rest.

Do Not Miss Diagnoses

• Compartment Syndrome: A condition where increased pressure within a muscle compartment (containing nerves and blood vessels) leads to inadequate blood supply to the tissues inside the compartment. It can cause severe, sharp pain, especially on the lateral aspect of the ankle, and is a medical emergency requiring prompt intervention.
• Deep Vein Thrombosis (DVT): Although less common in the ankle, DVT can cause sharp pain, swelling, and warmth in the affected leg. It is crucial to consider DVT in patients with risk factors such as recent surgery, immobilization, or cancer.
• Osteochondral Lesion of the Talus: A condition where a piece of cartilage and bone in the talus (ankle bone) becomes damaged, leading to sharp pain, especially with weight-bearing activities. It can be a result of trauma or repetitive microtrauma.

Rare Diagnoses

• Tarsal Coalition: An abnormal connection between two or more of the tarsal bones in the foot, which can cause sharp pain on the lateral side of the ankle or foot, especially during activities.
• Ganglion Cyst: A non-cancerous lump that can develop on the lateral aspect of the ankle or foot, causing sharp pain, especially if it compresses a nerve.
• Erythromelalgia: A rare disorder characterized by burning pain, heat, and redness in the hands and feet, which can sometimes present with sharp pain in the lateral ankle or foot.