Hello all
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I'd like to get your opinion on a case that arose this morning in my clinic.
Patient 21 years old, military, suffered 2 months ago from a inversion grade I ankle sprain on is right foot, he whas treatmented whid ice and took anti-inflammatory drugs during the first 24 hours after that the orthopedic immobilized the foot using plaster for about 1 month.
After this month he was discharged because he had no painful symptoms.
When he returned to is training after 3 weeks he started feeling pain on the outside of the foot that incapacitated to carry out is activities.
The patient brought all the exams he had done at the time of the sprain (Rx, and MRI).
During my initial evaluation I dint come across any signs of bruising, swelling or edema, however, performing inversion of the foot the patient complained of a very painful pain along the peroneal tendon and muscle activity of this muscle is practically non-existent because of the pain. In assessing the rearfot in prone position I found it to be in about 4 ° varus position and to assessing the rearfoot in heightbaring he had a valgus reafoot of about 2º.
My initial suspicions were that this is a peroneal tendinitis or perhaps a Sinus tarsi syndrome?
My inicial treatment plan is to perform a orthotic device whid a valgus extension to Increases pronatory torque under the metatarsal heads in order to reduce supinatory torque.
I would like to hear your opinion on this.
Thanks
André
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