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A 63-year-old man comes to clinic with a 2-hour history of ankle pain after stepping off the curb and twisting his ankle.
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- What other aspects of the history will be helpful in determining the etiology of his ankle pain?
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Ankle pain accounts for 20% of musculoskeletal complaints in outpatients.1 Etiologies of foot and ankle pain include trauma, inflammatory arthritis, sprains, shoe problems, and local manifestations of systemic diseases. The history is critical for determining which diagnoses to consider.
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Foot problems are rare among populations that do not wear shoes. Females are 9 times more likely than men to have foot problems. Chronic foot pain (lasting > 2 weeks) is more common than acute foot pain (lasting < 2 weeks).2
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Between 5 and 10 million ankle injuries occur in the United States each year. Of these injuries, 85% are sprains. Adult age 21 to 30 years old are at greatest risk.
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In an Italian study of 459 individuals, 21.8% had foot pain with standing, and 9.6% had pain at rest. The most common physical findings included calluses/corns (64.8%), hypertrophic nails (29.6%), hallux deformities (21.2%), and absent arterial pulses (15.9%).3 The Women's Health and Aging Study reported that 32% of disabled women had moderate to severe foot pain; obesity and osteoarthritis of the hands and feet were more common in these women.4 Ultimately, determining the etiology of foot pain depends on ...