Radiograph-negative ankle injury (peds): Difference between revisions
(Created page with "==Background== <ref>Gill PJ, Klassen T. Revisiting radiograph-negative ankle injuries in children: is it a fracture or a sprain? JAMA Pediatr. 2016; 170(1):e154147-e154147.</r...") |
No edit summary |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
<ref>Gill PJ, Klassen T. Revisiting radiograph-negative ankle injuries in children: is it a fracture or a sprain? JAMA Pediatr. 2016; 170(1):e154147-e154147.</ref> | *Pediatric ankle injuries are common (>2 million ED visits in North America per year)<ref name="JAMA RN Ankle Editorial">Gill PJ, Klassen T. Revisiting radiograph-negative ankle injuries in children: is it a fracture or a sprain? JAMA Pediatr. 2016; 170(1):e154147-e154147.</ref> | ||
<ref>Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016; 170(1):e154114-e154114.</ref> | *Historically, there has been concern about missing a potential growth plate fracture ([[Salter-Harris]] Type 1), which can rarely result in growth arrest<ref name="JAMA RN Ankle Editorial">Gill PJ, Klassen T. Revisiting radiograph-negative ankle injuries in children: is it a fracture or a sprain? JAMA Pediatr. 2016; 170(1):e154147-e154147.</ref> | ||
**This was commonly treated with immobilization (casting), follow-up imaging, and orthopedic referral (as opposed to adult [[ankle sprain]]) | |||
*Recent studies have questioned the need for this practice<ref="Injury MRI Ankle">6. Boutis K, Narayanan UG, Dong FF, et al. Magnetic resonance imaging of clinically suspected Salter-Harris I fracture of the distal fibula. Injury. 2010;41(8):852-856.</ref><ref="JAMA RN Ankle Study">Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016; 170(1):e154114-e154114.</ref> | |||
==Clinical Features== | ==Clinical Features== | ||
*Lateral ankle pain after inversion injury | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*[[Ankle fracture]] | |||
*[[Salter-Harris]] fracture | |||
*Ligimentous injury | |||
*Contusion of bone or soft tissue | |||
==Evaluation== | ==Evaluation== | ||
*Consider ankle x-rays | |||
==Management== | ==Management== | ||
==Disposition== | ==Disposition== | ||
*Outpatient | |||
==See Also== | ==See Also== | ||
Revision as of 17:02, 17 February 2017
Background
- Pediatric ankle injuries are common (>2 million ED visits in North America per year)[1]
- Historically, there has been concern about missing a potential growth plate fracture (Salter-Harris Type 1), which can rarely result in growth arrest[1]
- This was commonly treated with immobilization (casting), follow-up imaging, and orthopedic referral (as opposed to adult ankle sprain)
- Recent studies have questioned the need for this practice<ref="Injury MRI Ankle">6. Boutis K, Narayanan UG, Dong FF, et al. Magnetic resonance imaging of clinically suspected Salter-Harris I fracture of the distal fibula. Injury. 2010;41(8):852-856.</ref><ref="JAMA RN Ankle Study">Boutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children: occult growth plate fracture or sprain? JAMA Pediatr. 2016; 170(1):e154114-e154114.</ref>
Clinical Features
- Lateral ankle pain after inversion injury
Differential Diagnosis
- Ankle fracture
- Salter-Harris fracture
- Ligimentous injury
- Contusion of bone or soft tissue
Evaluation
- Consider ankle x-rays
Management
Disposition
- Outpatient
See Also
- Salter-Harris fractures
- [[Ankle diagnoses]
- Ankle fracture