DPM DPM Sports Medicine & Athletic Foot Injuries 2 — Questions and Answers
Question 1: The Ottawa Ankle Rules help clinicians determine the need for which diagnostic study?
- MRI
- Bone scan
- Radiographs (Correct answer)
- Doppler ultrasound
Correct answer: Radiographs
The Ottawa Ankle Rules are validated clinical decision rules to determine whether ankle or foot radiographs are necessary after an acute injury.
Question 2: Which structure is most commonly disrupted in a high ankle (syndesmotic) sprain?
- Anterior talofibular ligament
- Calcaneofibular ligament
- Anterior inferior tibiofibular ligament (Correct answer)
- Spring ligament
Correct answer: Anterior inferior tibiofibular ligament
The anterior inferior tibiofibular ligament (AITFL) is the most commonly injured ligament in syndesmotic high ankle sprains.
Question 3: Exertional compartment syndrome of the leg characteristically presents with pain that:
- Is constant and worsens with rest
- Begins during activity and resolves quickly after stopping (Correct answer)
- Is worst in the morning before activity
- Radiates from the lumbar spine
Correct answer: Begins during activity and resolves quickly after stopping
Chronic exertional compartment syndrome causes reproducible leg pain during activity that typically resolves within 15–30 minutes of stopping exercise.
Question 4: Which sesamoid bone is most commonly fractured in athletes?
- Medial (tibial) sesamoid (Correct answer)
- Lateral (fibular) sesamoid
- Os trigonum
- Accessory navicular
Correct answer: Medial (tibial) sesamoid
The medial (tibial) sesamoid is fractured more often than the lateral due to its greater weight-bearing role under the first metatarsal head.
Question 5: What is the preferred initial management for a first-time mild lateral ankle sprain?
- Surgical repair of the ATFL
- Immobilization in a cast for 6 weeks
- PRICE protocol and early functional rehabilitation (Correct answer)
- Corticosteroid injection
Correct answer: PRICE protocol and early functional rehabilitation
Grade I and II ankle sprains are best managed with PRICE (Protection, Rest, Ice, Compression, Elevation) and early functional rehabilitation to restore proprioception.
Question 6: Which imaging modality is best for evaluating a suspected stress fracture not visible on plain radiograph?
- CT scan
- Ultrasound
- MRI (Correct answer)
- Fluoroscopy
Correct answer: MRI
MRI is the gold standard for detecting stress fractures early, showing bone marrow edema before cortical changes appear on plain X-rays.
DPM DPM Sports Medicine & Athletic Foot Injuries 2
The Ottawa Ankle Rules help clinicians determine the need for which diagnostic study?