Differential Diagnosis for Weber A Ankle Fracture with Medial Sided Ankle Pain

• Single Most Likely Diagnosis
  • Medial malleolar fracture: This is the most likely diagnosis given the presence of a Weber A ankle fracture and medial sided ankle pain. The medial malleolus is the part of the tibia that forms the inner bump of the ankle, and a fracture here would cause pain on the medial side.
• Other Likely Diagnoses
  • Deltoid ligament sprain: The deltoid ligament is located on the medial side of the ankle and could be injured in conjunction with a Weber A fracture, causing medial sided pain.
  • Medial ankle impingement: This condition occurs when soft tissue becomes trapped between the talus and the medial malleolus, causing pain on the medial side of the ankle.
• Do Not Miss Diagnoses
  • Compartment syndrome: Although less likely, compartment syndrome is a serious condition that can occur after an ankle fracture. It is characterized by increased pressure within the muscle compartments of the leg, leading to pain, numbness, and potentially permanent damage if not promptly treated.
  • Neurovascular injury: Injury to the nerves or blood vessels surrounding the ankle could occur with a fracture and must be identified and treated promptly to prevent long-term damage.
• Rare Diagnoses
  • Stress fracture of the medial malleolus: While less common than an acute fracture, a stress fracture could cause medial sided ankle pain, especially in athletes or individuals with a history of repetitive stress on the ankle.
  • Osteochondral lesion of the talus: This is a condition where a piece of cartilage and bone in the talus (ankle bone) becomes damaged, which could cause medial ankle pain if the lesion is located on the medial aspect of the talus.