A 30-year-old man presents with pain, swelling, and ecchymosis around the ankle. He states that he twisted his ankle while jogging earlier today. On examination, there is swelling and tenderness over the back of the ankle. What could be the diagnosis and what should be the next steps?
This patient's history of a twisting injury while running and the physical findings suggest a possible Achilles tendon rupture. This is often seen in athletes and is characterized by a sudden sharp pain at the back of the ankle. The next step is a physical examination to check for a positive Thompson test (absence of foot plantar flexion when the calf is squeezed), which can suggest an Achilles tendon rupture. An ultrasound or MRI may be ordered for confirmation. Management typically involves orthopedic consultation for potential surgical intervention.