ANSWER
The radiograph demonstrates mild soft-tissue swelling and an oblique, mildly displaced fracture of the distal fibula. In addition, there is a small bone density adjacent to the medial malleolus, which could represent either an unfused accessory ossification center or a sequela of prior trauma.
On closer questioning, the patient acknowledged that a few months prior, she had stepped in a hole and been treated for a “broken bone.” She had been in a cast for an undisclosed period of time; at a follow-up appointment, the cast had been removed and the bone had been declared “healed.”
A new orthopedic consultation was obtained prior to the patient’s discharge from the hospital, which resulted in placement of a short leg cast.