Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: September 2, 2025 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

History of Present Illness (HPI)

The patient is an 18-year-old female who presents with a complaint of left ankle swelling. She reports that the swelling began after she rolled her ankle when stepping down from a step today after class. Despite icing her ankle, the swelling has not decreased. Notably, there is no bruising present. The patient's symptoms started acutely, and she has not experienced any similar episodes in the past.

Differential Diagnosis

Single Most Likely Diagnosis

  • Ankle Sprain: This is the most likely diagnosis given the patient's history of rolling her ankle and the presence of swelling without bruising. The mechanism of injury and the acute onset of symptoms are consistent with a sprain, which is a common injury in young adults.

Other Likely Diagnoses

  • Ankle Strain: While less common than a sprain, a strain (muscle injury) could also occur from the described mechanism, especially if the patient has a history of muscle weakness or poor ankle stability.
  • Contusion: Although the patient denies bruising, it's possible that a contusion (bruise) could develop over time, especially if there was significant trauma to the soft tissues around the ankle.

Do Not Miss Diagnoses

  • Fracture: Although less likely given the absence of severe pain or deformity, it's crucial to consider a fracture, especially if the patient has a history of osteoporosis or has experienced significant trauma. A fracture could be deadly if missed, as it may lead to complications like avascular necrosis or non-union.
  • Compartment Syndrome: This is a medical emergency that could occur after an ankle injury, characterized by increased pressure within the muscle compartments of the leg. It's essential to consider this diagnosis, especially if the patient reports severe pain, pallor, poikilothermia, paresthesia, or paralysis.

Rare Diagnoses

  • Osteochondral Lesion: This is a rare injury where a piece of cartilage and bone in the ankle joint is damaged. It could occur from a severe ankle sprain or trauma and might require surgical intervention.
  • Peroneal Tendon Subluxation: This rare condition involves the peroneal tendons slipping out of their normal position, which could happen after an ankle injury. It might require surgical repair to prevent chronic instability.

Related Questions

Should I treat the bacterial infection first, followed by the yeast infection, in a patient with a mixed vaginal infection?
What is the treatment for a throat infection suspected to be thrush?
What labs and initial management are recommended for acute kidney failure?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question