Of recent, a male in his 50s attended the clinic with a complain of right lateral ankle pain without any trauma indicated
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Occupation: maintainence officer
Medical Hx: Hypertension, hyperlipidemia, gout
Pain mainly below the distal tip of R lateral malleolus upon palpation or when the foot is in plantarflexion on non -WB and WB only.Pain tends to increase with prolonged walking.
Other findings: Unable to tip toe, full ROM of ankle joint, -ve anterior drawer's test, nil pain noted on peroneal tendons upon palpation, nil ligamentous laxity, ankle equinus. No tenderness along the peroneals.
Seen an Orthopaedic Dr in April 07-diagnosed at Peroneal tendinopathy as confirmed with ultrasound report.
Seen another Ortho Dr in May 07- diagnosed as recalcitrant of right P. longus tendinitis. Had an xray of R tib-fib done which it was reported as : No # or dislocation seen. Normal joint space and articular surfaces. No bone abnormalilty is demostrated.
March 08: Had physiotherapy /NSAIDS/customised foot orthoses with- no improvement at all.
*note: Xray of the right ankle (in "plantarflexion" view) as attached was ordered by the ortho doc in April 07.
Could the patient be suffering from sinus tarsi syndrome instead?:sinking:
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