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A 12-year-old boy with ankle pain: Case presentation
Clinical Chiropractic (2005) 8, 115—116
intl.elsevierhealth.com/journals/clch
CASE CHALLENGE
A 12-year-old boy with ankle pain: Case presentation Julie-Marthe Grenier a, Peter J. Scordilis a, Michelle A. Wessely b,* a
Palmer College of Chiropractic — Florida, 4777 City Center Parkway, Port Orange, FL 32129, USA Institut Franco-Europeen de Chiropractique (IFEC), Department of Radiology, 24 Boulevard Paul Vaillant Couturier, 94200 Ivry Sur Seine, France
b
Received 24 June 2005; accepted 30 June 2005
Clinical presentation
Clinical findings and examination
History
The patient appeared tired and experienced general discomfort in the right ankle area. The vital signs were all within normal limits. The patient was afebrile at the time of examination. A review of the organ systems was unremarkable. The right ankle joint was swollen, slightly red and warm to the touch on the medial aspect in the area of the malleolus, extending proximally to the mid calf. Pain was aggravated by light palpation. No rash, abrasion or skin lesions were present. General orthopedic tests for the ankle region were negative. Radiographs were taken (Figure 1).
A 12-year-old boy presents with pain in his right lower leg. The pain had an insidious onset and gradually increased over the course of a week. The patient was involved in multiple sports such as football and basketball, but neither he nor his parents could remember a specific injury. The patient had limited his athletic participation the prior week because he had suffered from a minor throat infection. He reported feeling ‘‘miserable and tired’’ despite the resolution of the throat infection, for which he did not receive treatment.
(1) What are your imaging findings? (2) What is the most likely diagnosis? (3) How will you manage this patient?
* Corresponding author. Tel.: +33 1 4515 8910; fax: +33 1 4515 8911. E-mail address: [email protected] (M.A. Wessely). 1479-2354/$30.00 # 2005 The College of Chiropractors. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.clch.2005.06.007
116
J.-M. Grenier et al.
Figure 1 A 12-year-old boy presented with pain in his right lower leg. Lateral and AP ankle plain film radiographs were performed.
intl.elsevierhealth.com/journals/clch
CASE CHALLENGE
A 12-year-old boy with ankle pain: Case presentation Julie-Marthe Grenier a, Peter J. Scordilis a, Michelle A. Wessely b,* a
Palmer College of Chiropractic — Florida, 4777 City Center Parkway, Port Orange, FL 32129, USA Institut Franco-Europeen de Chiropractique (IFEC), Department of Radiology, 24 Boulevard Paul Vaillant Couturier, 94200 Ivry Sur Seine, France
b
Received 24 June 2005; accepted 30 June 2005
Clinical presentation
Clinical findings and examination
History
The patient appeared tired and experienced general discomfort in the right ankle area. The vital signs were all within normal limits. The patient was afebrile at the time of examination. A review of the organ systems was unremarkable. The right ankle joint was swollen, slightly red and warm to the touch on the medial aspect in the area of the malleolus, extending proximally to the mid calf. Pain was aggravated by light palpation. No rash, abrasion or skin lesions were present. General orthopedic tests for the ankle region were negative. Radiographs were taken (Figure 1).
A 12-year-old boy presents with pain in his right lower leg. The pain had an insidious onset and gradually increased over the course of a week. The patient was involved in multiple sports such as football and basketball, but neither he nor his parents could remember a specific injury. The patient had limited his athletic participation the prior week because he had suffered from a minor throat infection. He reported feeling ‘‘miserable and tired’’ despite the resolution of the throat infection, for which he did not receive treatment.
(1) What are your imaging findings? (2) What is the most likely diagnosis? (3) How will you manage this patient?
* Corresponding author. Tel.: +33 1 4515 8910; fax: +33 1 4515 8911. E-mail address: [email protected] (M.A. Wessely). 1479-2354/$30.00 # 2005 The College of Chiropractors. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.clch.2005.06.007
116
J.-M. Grenier et al.
Figure 1 A 12-year-old boy presented with pain in his right lower leg. Lateral and AP ankle plain film radiographs were performed.