“I twisted my right ankle, and it hurts when I walk.”
History
Tom, a 26-year-old runner, came in to the office todaycomplaining of constant pain in the right ankle. While running hisusual route, he accidentally stepped on a branch lying in his path,twisting his ankle inward. He denies hearing a “pop.” He was ableto walk, or limp, the remaining quarter mile back to his home,where he immediately elevated and iced the ankle for 30 minutes. Hetook two acetaminophen 325 mg, showered and dressed for work, anddrove to his place of employment. He continued to experiencesignificant pain in the ankle, which is worse when walking. Hisfoot became swollen. Since his job in a sporting goods storerequires that he be on his feet most of the day, he was unable tocontinue his normal workday, and made a same-day appointment to beseen. He has no chronic diseases, takes no medication. He sprainedthe ankle last year but was able to manage that injury at home withacetaminophen.
Assessment
A 26-year-old, otherwise healthy male presents limping into theexamination room, holding his right shoe in his hand. He grimaceswith partial weight-bearing of the affected foot. He has localecchymosis and 1+ edema over the anterolateral ligaments of theright ankle. Capillary refill, pulses, and sensation of the footand toes are intact. There is no lateral or anterior instability ofthe joint or tendons. X-rays of the ankle and foot are negative forfracture or dislocation. He has a grade I lateral ankle sprain.
- What medication would be appropriate to prescribed for thispain?
- What education is required for the medication you chose?
