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Responses

Fridah

Based on the case study, the patient reported pain in both of her ankles, though she is

more concerned about her right ankle. She suffered the injury while playing soccer over the

weekend. Though she can bear the weight, she is uncomfortable. Possible differential diagnoses

include ankle strain, sprain, fracture and Achilles tendinitis. Ankle strain is caused by single

trauma like slipping or falling when running or jumping during sport. The condition is

attributable to longer-term overuse of muscles in the ankle and is more likely to occur among

marathon runners, soccer or American football players, gymnast or a dancer (Iqbal et al., 2021).

Ankle strain is characterized by pain that either appears immediately or gradually over time

because of the overusing of the ankle muscles. Other symptoms include swelling, redness and

inflammation of the strained area. Additional symptoms include muscle spasms, cramping and

weak muscle in the ankle.

An ankle sprain is attributable to rolling, twisting or turning the ankle in an abnormal

way. This results in the stretching or tearing of tissues or ligaments that aids in holding the ankle

bones together (Chen, Mclnnis & Brog-Stein, 2019). Ligaments stabilize joints and prevent

excessive movements. A sprained ankle happens when the ligaments are forced beyond a range

of motion. Common symptoms include pain, particularly when bearing weight on the impacted

foot, tenderness on touching the ankle, swelling, bruising, restricted range of motion, and ankle

instability, in addition to a popping sensation or sound during the occurrence of the injury (Chen

et al., 2019).

Achilles tendinitis occurs when the large tendon running down the back of the lower leg

is irritated and inflamed. It is an acute inflammation of a tendon, considered the body’s natural
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response to injury (Katz, 2021). The condition results in swelling, pain or irritation. Tendinitis is

associated with the overuse of tendinitis, which is mostly utilized for jumping, running, walking

and climbing.

Among the suggested differential diagnosis, ankle fracture is the least likely condition. In

a fractured ankle, one or more bones making up the ankle joint are broken. Common symptoms

associated with a fractured ankle include immediate and severe pain, swelling, bruising and

inability to put any weight on the injured ankle and numbness and coolness in the foot. In this

case study, the affected ankle can support the patient’s weight, thus ruling out an ankle fracture.

The most likely condition in this case study is the ankle sprain. The condition is characterized by

the popping sound when the injury occurs. This is in addition to pain when the ankle bears the

weight in addition to swelling. The patient exhibits the majority of these symptoms, hence the

most likely diagnosis.

References

Chen, E. T., McInnis, K. C., & Borg-Stein, J. (2019). Ankle sprains: evaluation, rehabilitation,

and prevention. Current sports medicine reports, 18(6), 217-223.

Iqbal, A., McLoughlin, E., Beale, D., James, S. L., & Botchu, R. (2021). A rare pattern of

ligamentous injury of the ankle: a case report and review of the literature. The Journal of

Foot and Ankle Surgery, 60(4), 870-872.

Katz, J. N. (2021). Platelet-rich plasma for osteoarthritis and achilles tendinitis. JAMA, 326(20),

2012-2014.
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Rebecka
The case study entails a 15-year-old Caucasian male with “dull pain in both knees”. The

pain began two months ago and worsens with running, squatting or sitting for long periods with

his knees bent. Possible differential diagnoses include patellofemoral pain syndrome, Sinding-

Larsen-Johansson syndrome, Osgood Schlatter’s disease and osteochondritis dissecans of the

knee.

Patellofemoral pain syndrome or runner’s knee is the pain at the front of the knee around

the kneecap (patella). The condition is prevalent among athletes that engage more in running and

jumping (Gaitonde et al., 2019). The knee pain augment with the running, walking up or down

the stairs or sitting for longer periods or squatting. The condition is attributable to overuse mostly

due to physical activities that repeatedly stresses the knee. This is in addition to patellar

malalignment.

Sinding-Larsen-Johansson Syndrome is a temporary injury to the growth plate in the

knee, particularly where the kneecap connects to the patellar tendon (Fischer, 2021). In most

cases, the conditions impact on the kids and teens aged 10 to 14 and is attributable to overuse

from taking part in sports. The overuse can be due to running, jumping, kicking or any other

activity that requires exerting a lot of force among kids. Common symptoms of this condition

include sharp pain at the bott of the kid’s knee, swelling, tender knee and difficulties bending the

knee (Fischer, 2021). On the other hand, torn meniscus is a knee injury that cause pain, swelling

and stiffness. The condition is characterized by the popping sensation, stiffness, pain when

twisting or rotating the knee, difficulty straightening the knee fully and feeling as though the

knee is locked when trying to move and feeling as if the knee is giving way.

Osteochondritis dissecans is a joint condition in which the bone underneath the cartilage

of a joint dies because of the lack of blood flow (Andriolo et al., 2020). The bone cartilage can
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then break loose, which causes pain and possible hinders joint motion. The condition mostly

affects kids and adolescents. Symptoms might appear after an injury to the joint or few months

of strenuous activity, like jumping or running those impacts on the joint.

Rejected and possible diagnosis

The rejected diagnosis is Osgood-Schlatter disease, which mostly occur during

development spurts, in which the bone muscles, tendon among other structures change fast

(Corbi et al., 2022). Common symptoms include knee pain and tender tibial tubercle, swelling at

the tibial tubercle and tight muscle in the thigh. However, the patient does not exhibit these

symptoms except for knee pain. In this case study, the possible condition is Patellofemoral pain

syndrome characterized by knee pain that increases with walking, running, climbing up or down

the stairs in addition to prolonged sitting. The patient exhibits most of these symptoms, hence the

most likely diagnosis.

References

Andriolo, L., Crawford, D. C., Reale, D., Zaffagnini, S., Candrian, C., Cavicchioli, A., &

Filardo, G. (2020). Osteochondritis dissecans of the knee: etiology and pathogenetic

mechanisms. A systematic review. Cartilage, 11(3), 273-290.

Corbi, F., Matas, S., Álvarez-Herms, J., Sitko, S., Baiget, E., Reverter-Masia, J., & López-Laval,

I. (2022, May). Osgood-Schlatter Disease: Appearance, Diagnosis and Treatment: A

Narrative Review. In Healthcare (Vol. 10, No. 6, p. 1011). MDPI.

Fischer, A. N. (2021). Sinding-Larsen-Johansson Syndrome. In Common Pediatric Knee

Injuries (pp. 63-68). Springer, Cham.

Gaitonde, D. Y., Ericksen, A., & Robbins, R. C. (2019). Patellofemoral pain

syndrome. American family physician, 99(2), 88-94.

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