Referral to physical therapy of a previously undiagnosed ankle metastatic lesion

摘要

A 59-year-old woman was referred to physical therapy with a 5-month .history of progressive worsening ankle pain after a twisting injury sustained while walking in her home. The previous diagnostic assessment by her primary care physician and podiatrist included radiographs that were formally reported as showing degenerative changes and evidence of old bimalleolar fractures (Figure 1). The patient was subsequently referred to physical therapy for conservative management. At evaluation, she reported worsening of diffuse ankle pain, redness, and swelling since the initial injury. In addition, she reported a significant history of a prior ankle fracture (23 years earlier) and a 30-pack-year history of smoking.