Associated injuries

What might seem like an ankle sprain might mask other injuries, some of which are serious enough to warrant surgery. A differential diagnosis for ankle sprains must be considered.

With the correct examination and imaging the following can be diagnosed:

-       Tendon tears or inflammation (tenosynovitis), the most serious being an Achilles tendon tear*. Other commonly affected tendons are the tibialis posterior, tibialis anterior, and the peroneals (brevis and longus) which can also dislocate.

-       Fractures*: most commonly ankle bone fractures (tibia and fibula), or fifth metatarsal; less commonly talar bone, posterior or lateral process of the talus, anterior process of the calcaneus

-       Sprains of other ligaments such as subtalar sprains or talonavicular sprains.

-       Osteochondral lesions of the talus or tibia.*

-       Muscle strains or bruises

-       Midfoot or Lisfranc joint sprain or fracture*

*These conditions are likely to require urgent surgery in the days/weeks following the injury, and if misdiagnosed can carry serious consequences that will affect outcomes.