Image Quiz
Painful Ankle in a Thirteen-Year-Old Boy
Harish S. Hosalkar, MD, Lawrence Wells, MD, Franklin W. Yates, MA, and Purushottam Gholve, MD*
Department of Orthopaedic Surgery, Childrens' Hospital of Philadelphia, Philadelphia, Pennsylvania. E-mail address for L. Wells: wellsl@email.chop.edu
A thirteen-year-old boy presented with a history of right ankle pain of approximately five years' duration and limitation of ankle motion for about six months. He reported having pain at night, which was often alleviated with use of nonsteroidal anti-inflammatory medications, including aspirin. Physical examination revealed a well-developed boy with mild swelling of the ankle as well as limitation of active terminal dorsiflexion and plantar flexion of the ankle because of pain. He also had some atrophy of the ipsilateral calf. No neurovascular abnormalities were present. Previous radiographs (Fig. 1) and magnetic resonance images (Fig. 2) were made available to us, and a computed tomographic scan of the involved region was made at our institution (Fig. 3).
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