Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive ankle pain, exacerbated by weight-bearing activities and prolonged standing. Reports morning stiffness lasting <30 minutes, localized swelling, and mechanical symptoms including crepitus and occasional locking. Pain is described as a dull ache, localized to the tibiotalar joint, with functional limitations in ambulation and activities of daily living.
Clinical Examination Findings
Physical examination reveals peri-articular swelling and tenderness along the tibiotalar joint line. Range of motion (ROM) is restricted, particularly in dorsiflexion and plantarflexion, with palpable crepitus during passive movement. Gait analysis demonstrates an antalgic pattern. Neurovascular status is intact distally. No signs of acute inflammatory arthropathy or ligamentous instability.
Treatment Protocol
Conservative management initiated: activity modification, weight management, and use of supportive footwear or orthotics. Prescribed NSAIDs for pain control. Physical therapy referral for strengthening of stabilizing musculature and ROM exercises. Consider intra-articular corticosteroid or hyaluronic acid injections if symptoms persist. Discussed potential for surgical consultation (arthrodesis or arthroplasty) for refractory cases.