In some cases, patients presenting this is rare, we want to be certain we, as physical therapists, are able to help.
Some of the symptoms we look for include:
- Fever, chills, night sweats (increased risk of infection or cancer)
- Weight loss (concern of cancer or infection)
- Recent infection (increased risk of infection)
Medication-specific concerns include:
- Steroids (risk of osteoporosis)
- Anti-coagulants (risk of bleeding)
- Immunosuppressants (risk of infections)
The Ottawa Ankle Rules were created to determine if a patient needs X-rays following an acute ankle injury. A patient needs X-rays if there is:
- Pain in the malleolar zone (see image below)
- Any of the following:
- Bone tenderness along the distal 6 cm of the back edge of the tibia or tip of the medial malleolus
- The inability to bear weight both immediately and in the emergency department for four steps
Image credit http://www.ohri.ca/emerg/cdr/docs/cdr_ankle_poster.pdf
- Martin, Robroy L. et al. “Achilles Pain, Stiffness, And Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018.” Journal of Orthopaedic & Sports Physical Therapy, Vol. 48, No. 5, 2018, pp. A1-A38. Journal of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2018.0302.