Musculoskeletal: what is different in children? Running; steps in hole; ankle sprain; my foot hurts

Excerpt

This 11-year-old female was jumping around on a moonwalk. She misstepped and twisted her left ankle and foot. She heard a pop and the ankle was immediately sore. She thought she had fractured it. The ankle became more sore over the next 30 min and swelling was increasing over the lateral aspect of the ankle. When the patient got home, her parents became concerned and brought her to our Emergency Room (ER). On the way to the ER, the patient also began to complain of foot pain. When she arrived at the ER, she clearly had swelling of her left ankle and was tender over the lateral malleolus. When her foot was examined, it was decided that she was sore and tender over the forefoot but the examiner was not certain as to the exact site of maximal tenderness. She had no other problems and radiographs of the ankle and foot were obtained. An anteroposterior image of the feet is shown in Fig. 1. What do you see?

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