10-21-2008, 09:27 AM
A 21 year old woman goes to her university physcian for sprained ankle. She was playing
basketball when she landed on her right foot and forcefully inverted it. She was in
excruciating pain at first and the ankle immediately swelled. She was brought to health
service by her friend in her car. Her past medical history is unremarkable and this is her
first visit to her physcian in about 4 years. Her mother was recently diagnosed with breast
cancer at 52. On physical examination her temperautre is normal and her bp is 126/72mm.The
CVS, CNS and abdominal exmination is unremarkable. Her ankle is swollen and is painful on
movement. A radiograph shows marked soft tissue swelling without a fracture in her ankle.
Her ankle is splinted and she is asked to visit again after 2 weeks. She is asked to use ice
over the ankle, use ibuprofen and elevate the ankle as much as possible. Which is the next
step in management?
A.Genetic testing for breast cancer
B. MRI of ankle
C. mammography
D. Pap Smear
E. Radionuclide bone scan
basketball when she landed on her right foot and forcefully inverted it. She was in
excruciating pain at first and the ankle immediately swelled. She was brought to health
service by her friend in her car. Her past medical history is unremarkable and this is her
first visit to her physcian in about 4 years. Her mother was recently diagnosed with breast
cancer at 52. On physical examination her temperautre is normal and her bp is 126/72mm.The
CVS, CNS and abdominal exmination is unremarkable. Her ankle is swollen and is painful on
movement. A radiograph shows marked soft tissue swelling without a fracture in her ankle.
Her ankle is splinted and she is asked to visit again after 2 weeks. She is asked to use ice
over the ankle, use ibuprofen and elevate the ankle as much as possible. Which is the next
step in management?
A.Genetic testing for breast cancer
B. MRI of ankle
C. mammography
D. Pap Smear
E. Radionuclide bone scan