A 39-year-old woman presents to your emergency department complaining of right ankle pain following an injury last night. She states that she got out of bed during the night, somehow misstepped, and fell to the floor. She is unable to bear weight on the ankle and is experiencing severe pain.
Her medical history is significant for being one month status post Chiari decompression. She also has a history of bipolar disorder.
Examination of the patient’s right ankle shows it to be moderately swollen with some bruising laterally. The patient has limited flexion and extension, and her ankle is extremely tender to palpation. Her distal pulses and her sensation are intact.
Radiographs of the right ankle are shown. What is your impression?
