Differential Diagnosis for Ankle Injury with Inward Roll
When someone's ankle rolls inward or medially, several injuries can occur. Here's a differential diagnosis organized into categories:
- Single most likely diagnosis
- Ankle sprain: This is the most common injury when the ankle rolls inward. The medial ligaments, particularly the deltoid ligament, are stretched or torn, leading to pain, swelling, and instability.
- Other Likely diagnoses
- Medial ankle fracture: A fracture of the medial malleolus or other bones in the medial ankle can occur, especially if the force of the roll is significant.
- Peroneal tendon injury: The peroneal tendons, which run along the lateral ankle, can be stretched or torn when the ankle rolls inward, causing pain and weakness.
- Syndesmotic injury: The syndesmosis, a ligamentous complex between the tibia and fibula, can be injured when the ankle rolls inward, leading to pain and instability.
- Do Not Miss diagnoses
- Compartment syndrome: Although rare, compartment syndrome is a potentially devastating condition that can occur after an ankle injury. Increased pressure within the muscle compartments can lead to nerve and muscle damage, making prompt diagnosis and treatment crucial.
- Fracture with dislocation: A fracture with dislocation of the ankle joint can occur, which requires prompt reduction and stabilization to prevent long-term damage.
- Rare diagnoses
- Osteochondral lesion: An osteochondral lesion, where a piece of cartilage and bone is damaged, can occur in the ankle joint, especially with a severe roll.
- Nerve injury: Injury to the nerves surrounding the ankle, such as the peroneal or tibial nerves, can occur, although this is relatively rare.
- Vascular injury: Injury to the blood vessels surrounding the ankle, such as the posterior tibial artery, can occur, although this is rare and usually associated with more severe trauma.