If the ankle inspection and gait is largely normal, then you need to think of these 2 possibilites: Peroneal tendon subluxation and ankle instability.
- Look
- Stand and see - mention no pes planus, pes cavus
- Walk
- Normal again
- Return
- Do screening tests - tip toe, toes up
- Observe lateral subluxation of tendons
- Sit and ask “where is your pain?”
- Palpate ottawa ankle rules regions
- Anterior drawer, talar tilt
- Screen nerve sensation - “CPN and Sural nerve neuropraxia associated with ankle injuries”
- Palpate anterior joint line with plantarflexion for tenderness - osteochondral defect
- Check pulses
- Peroneal instability
- Dorsiflex and evert against resistance to identity subluxation of peroneal tendons
- Beighton score