CASE
During recess, a 12-year-old boy was running across wet grass when he suddenly slipped. He fell forward and twisted his right ankle. The school nurse examined him briefly and immediately sent him to the urgent care clinic for further evaluation. At the clinic, he stated that his foot had “completely twisted outward” and that he had had to “twist it back.” Diffuse swelling was noted over the lateral and medial malleoli, with extreme tenderness to palpation over the lateral aspect of the ankle. The neurovasculature was intact. Pain prevented the patient from allowing any passive range of motion of his ankle, and he was unable to walk independently. Examination of the hips and knees was unremarkable. Radiographs of the right ankle and foot were ordered, along with a comparison view of the left ankle (Figure 1, Figure 2, Figure 3). What do these images show?
