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Occult bimalleolar ankle fracture

Case contributed by Roberto Schubert
Diagnosis certain

Presentation

The patients left ankle was hit by the bumper of a car when he was on a bike.Radiographs showed no fracture. MRI was obtained 3 weeks later for persistent pain on weight bearing.

Patient Data

Age: 30
Gender: Male

Non-displaced fracture of the medial malleolus involving the joint surface. Subchondral bone bruises of the anterolateral tibia and talar dome, and also of the distal fibula, which seems to show a tiny lateral cortical breach.

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