Orthopedics · Model history
A twisted ankle: a model orthopedic history
- Setting
- Orthopedic same-day clinic
- Patient
- Mr. Jin, 28, has right lateral ankle pain, swelling, and bruising after landing awkwardly during basketball four hours ago.
- Listen
- 3 min
After listening
Say the next question
Read the patient’s answer, say your next question aloud, then reveal the model.
“No. I managed two steps, then my teammates helped me off the court.”
He could not take four steps immediately after injury. Ask the separate present-time weight-bearing question.
Can you take four steps now, even with a limp?
Model interview
Full transcript
- Doctor
Mr. Jin, I'm Dr. Parker. Keep the ankle supported while we talk. Walk me through exactly how you injured it.
- Patient
About four hours ago I came down from a rebound in basketball. My right foot rolled inward, and I fell.
- Doctor
Did you feel or hear a pop or crack when it happened?
- Patient
No crack. I felt a sharp pull on the outside of the ankle.
- Doctor
How quickly did the swelling and bruising appear?
- Patient
It swelled within minutes. The bruising became obvious over the next couple of hours.
- Doctor
Please point with one finger to where it hurts most.
- Patient
Right over this outer ankle bone and just below it.
- Doctor
Were you able to take four steps immediately afterward?
- Patient
No. I managed two steps, then my teammates helped me off the court.
- Doctor
Can you take four steps now, even with a limp?
- Patient
No. Putting my full weight on it is too painful.
- Doctor
Have you noticed any numbness or tingling in the foot?
- Patient
No.
- Doctor
Has the foot felt cold or looked unusually pale or blue?
- Patient
No. The color and temperature seem normal.
- Doctor
Was there any open wound or an obvious change in the shape of the ankle?
- Patient
No open cut and no obvious deformity, just swelling.
- Doctor
Have you injured this ankle before?
- Patient
I had a mild sprain about three years ago, but it healed completely.
- Doctor
What have you done for it since the injury?
- Patient
I stopped playing, put ice on it, and kept it raised. I haven't taken pain medicine.
- Doctor
How painful is it while supported, and what makes the pain worse?
- Patient
It's about four out of ten while I keep it still, but it becomes sharp and much worse if I move the ankle or try to stand.
- Doctor
Do you have any major medical condition or take any regular medicine?
- Patient
No medical problems and no regular medicine.
- Doctor
Do you have any medication allergies?
- Patient
No known medication allergies.
- Doctor
What activities are most important for you to get back to?
- Patient
I sit at a computer for work, but basketball is what I'm worried about. I want to know whether it's broken and when I can play again.
- Doctor
You rolled the right foot inward four hours ago and developed rapid swelling, bruising, and pain over the outer ankle. You could not take four steps then and still cannot now, but you report no wound, deformity, numbness, or change in foot color or temperature. Is that accurate, and is there anything else I missed?
- Patient
That's all correct.
- Doctor
I'll examine the bones, ligaments, movement, circulation, and sensation. Because you cannot take four steps and have pain near the ankle bone, an X-ray may be appropriate after the examination. We'll protect the ankle now and base return to basketball on the findings and your recovery, not on a fixed date.
- Patient
Okay. I appreciate the clear answer.
Flow at a glance
The route through the history
- Reconstruct the landing and direction of force
- Establish immediate swelling and pain location
- Ask separately about four-step weight bearing
- Screen for open injury, deformity, and neurovascular change
- Review prior injury and self-care
- Identify work and sport goals
- Summarize before examination and imaging decision
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Editorial record
Tied to one reviewed case
This model uses a fictional Bedside English case as its source. The page and pre-generated WAV audio are checked against the same transcript and source-case fingerprints.
Editorial update: