Microsoft Excel

You will analyze the data you collected and provided in your assignment last week. As you are working on each of the steps below, think about the analysis that you will provide to the research team. Follow the steps below to complete this analysis.

Copy the file you created in week 5 and rename the new one “YourName_COMP150_W6_Assignment”.
Open the file and duplicate the sheet where the initial table and data were created
Rename the new sheet as “sorting & filters” and move it to the right of the original sheet

Make the data look professional by using formatting options such as borders and table styles to place the data into a table.
Select one of the text-based data columns such as names, cities, or addresses and sort the data by Z to A.
Create a custom filter to any part of the data except where you did the sort. For example, if you sorted by patient’s name, then filter another set of data.

Duplicate the original sheet again and rename it as “conditional formatting”. Move it right after the “sorting & filters” sheet.

Implement conditional formatting to any of the number-based data sets. For example, showing higher numbers in green, while showing lower numbers in red.
Add an IF function and apply it to the entire set. For example, you could create a function that says if x number is higher than x number, then you are at risk. The purpose is to show how an IF function works so creativity it is permitted in how you use the function.

Use the “conditional formatting” sheet to create a pivot table.

The pivot table needs to be on its own sheet.
The pivot table needs to be meaningful so make sure to select data that will make it clear for your analysis.
The pivot table should have data selected on the columns, rows, and values fields. Make sure to consider the data when adding the values selection

Create a minimum of two charts. Make sure to select the right chart that explains your analysis. Each chart should be on its own sheet and should have a title. Make sure the purpose of the chart is self-explanatory just by looking at it.
Update the documentation sheet

Update the date.
Add all the new rows for the sheets created.
Provide a brief written analysis for each of the new sheets. Explain what you want the research team to learn about each sheet.

Review all the sheets to ensure it looks professional. Try to keep the same style, colors, and formatting, Make sure the file is named “YourName_COMP150_W6_Assignment” and submit the file.

SHOW MORE…

ADV HEALTH ASSESSMENT

Episodic/Focused SOAP Note Template

Patient Information:

Initials, Age, Sex, Race

S.

CC (chief complaint) a BRIEF statement identifying why the patient is here – in the patients own words – for instance “headache”, NOT “bad headache for 3 days.

HPI: This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was headache, the LOCATES for the HPI might look like the following example:

Location: head
Onset: 3 days ago
Character: pounding, pressure around the eyes and temples
Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia
Timing: after being on the computer all day at work
Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not completely better
Severity: 7/10 pain scale

Current Medications: include dosage, frequency, length of time used and reason for use; also include OTC or homeopathic products.

Allergies: include medication, food, and environmental allergies separately (a description of what the allergy is ie angioedema, anaphylaxis, etc. This will help determine a true reaction vs intolerance).

PMHx: include immunization status (note date of
last tetanus for all adults), past major illnesses and surgeries. Depending on the CC, more info is sometimes needed

Soc Hx: include occupation and major hobbies, family status, tobacco & alcohol use (previous and current use), any other pertinent data. Always add some health promo question here – such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system.

Fam Hx: illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason for death of any deceased first degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent.

ROS: cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows:
General:
Head:
EENT: etc. You should list these in bullet format and document the systems in order from head to toe.

Example of Complete ROS:
GENERAL: Denies weight loss, fever, chills, weakness or fatigue.
HEENT: Eyes: Denies visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat: Denies hearing loss, sneezing, congestion, runny nose or sore throat.
SKIN: Denies rash or itching.
CARDIOVASCULAR: Denies chest pain, chest pressure or chest discomfort. No palpitations or edema.
RESPIRATORY: Denies shortness of breath, cough or sputum.
GASTROINTESTINAL: Denies anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.
GENITOURINARY: Burning on urination. Pregnancy. Last menstrual period, MM/DD/YYYY.
NEUROLOGICAL: Denies headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.
MUSCULOSKELETAL: Denies muscle, back pain, joint pain or stiffness.
HEMATOLOGIC: Denies anemia, bleeding or bruising.
LYMPHATICS: Denies enlarged nodes. No history of splenectomy.
PSYCHIATRIC: Denies history of depression or anxiety.
ENDOCRINOLOGIC: Denies reports of sweating, cold or heat intolerance. No polyuria or polydipsia.
ALLERGIES: Denies history of asthma, hives, eczema or rhinitis.

O.

Physical exam: From head-to-toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History.
Do not use WNL or normal. You must describe what you see. Always document in head to toe format i.e. General: Head: EENT: etc.

Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines)

A

.

Differential Diagnoses (list a minimum of 3 differential diagnoses).Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence based guidelines.

P.

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.
References
You are required to include at least three evidence based peer-reviewed journal articles or evidenced based guidelines which relates to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.

2021 Walden University, LLC

Page 1 of 3 A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform?
With regard to the case study you were assigned:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study you were assigned.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify
at least fivepossible conditions that may be considered in a differential diagnosis for the patient.

By Day 3 of Week 8

Postan episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. Case 2: Ankle Pain

Episodic/Focused SOAP Note

Patient Information:

46 y/o female

S.

CC (chief complaint) “Pain in both ankles, but my right ankle hurts more than the left.

HPI: The patient is a 46-year-old female who comes into the clinic with complaints of bilateral ankle pain. The patient is however more concerned about her right ankle. The patient reports she was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. The patient reports pain to the left ankle is 4/10 and pain to right ankle is 10/10. The patient reports pain to the bilateral ankle began 11 months ago after a motorbike accident that killed her husband. Patient reports the Tramadol prescribed three months ago by her PCP has been “helping somehow”, but the pain to the right ankle is “unbearable”

Current Medications:

1. Bayer Multivitamin 1 tab daily
1. Caltrate 600+D plus 2 tabs PO daily
1. Metoprolol tartrate Po 1 tab daily
1. Tramadol 50mg PO 1 tab Q6 hours as needed
1. Effexor 75mg PO 1 tab daily.

Allergies:

1. Latex(hives)
1. Cipro(facial swelling)

PMHx: Hypertension; Vitamin D deficiency; depression

PSHx: C-section x2

Sexual/reproductive history: Heterosexual, a widow, has 2 daughters, just started dating a few days ago, not sexually active

Social history: Lives with her 2 daughters in a 2 story family home, has smoke and carbon monoxide detectors, drives and uses seatbelt all the time, car equipped with Bluetooth, denies using a cell phone while driving, rides a bicycle in the park 3x a week, denies wearing a helmet; drinks 2 -3 glasses of wine a week; denies smoking; denies illicit drugs, works an average of 36 hours a week as a teacher; volunteers to teach soccer in her neighborhood; teaches Sunday school on Sundays.

Immunization history: tetanus booster 6 months ago, flu shot (October 2019)

Family history: Mother: hypertension, Diabetes type II; Father: Hypertension, Lung cancer (deceased 14 years ago); sister: CAD, CVA; brother: hypertension; paternal grandfather: (deceased) hypertension, MI; paternal grandmother: (deceased) ESRD, diabetes type II, hypertension; maternal grandfather: prostate cancer, DM2, osteoporosis; maternal grandmother: COPD, hypertension, Parkinson’s disease, dementia.

ROS:

GENERAL: A Pleasant appearing AA female in mild distress; appropriately dressed; speech is clear and logical; negative for fever, chills
HEENT:
Nose: symmetrical, no drainage, no nasal congestion, denies loss of smell
Eyes: No visual loss, blurred vision, double vision, or yellow sclerae.
Ears: No hearing loss, no tinnitus, no drainage.
Throat and mouth: Denies difficulty chewing or swallowing, no dental caries, no erythema
SKIN: no rashes or itching noted; scar to lower abdomen
CARDIOVASCULAR: Denies chest pain, or chest discomfort. No history of arrhythmia. No palpitations or edema. No cyanosis, clubbing, noted.
RESPIRATORY: Denies shortness of breath; denies cough, and/or sputum. Lungs clear to auscultation
GASTROINTESTINAL: Abdominal sound present x4 quadrants, no changes in bowel habits; no abdominal pain; no palpated mass.
GENITOURINARY: Denies dysuria, frequency. Last Pap smear 3 months ago; menstrual period irregular, last menstrual period on 05/26/2020.
NEURO: denies syncope, headache, paralysis, ataxia, numbness, or tingling in the extremities.
MUSCULOSKELETAL: Bilateral ankle pain, right ankle swelling, denies stiffness.
HEMATOLOGIC: No anemia, bleeding, or bruising.
LYMPHATICS: No enlarged nodes. No history of splenectomy.
PSYCHIATRIC: History of depression, on Effexor 75mg PO daily; reports occasional insomnia.
ENDOCRINOLOGIC: Denies polyuria or polydipsia; denies cold or heat intolerance.

Physical exam:

VS: BP 158/84; P 94; R 18; T 98.0 oral; 02 100% RA Wt 156 lbs; Ht 66
General: Appears clean, cooperative, in mild distress
HEENT: Normocephalic, PERRLA. Mucosae moist. No masses. Normal thyroid. Last eye exam 1 year ago. Last dental exam 4 months ago
Chest/Lungs: Symmetrical; clear to auscultation, no rales, rhonchi, rubs
Cardiovascular: S1 & S2 present with no murmurs, RRR. No cyanosis. RLE edema +1; Pulses +2 in BLE
CNS: Alert, oriented; able to recall information; speech appropriate. Normal gait.
Neuro: 2-12 grossly intact.
Musculoskeletal: Strength 5/5 BUE, LLE 4/5, RLE unable to assess due to pain. Gait unable to assess due to BLE pain
Sensation: pain to bilateral ankles. DTR 2+.
Skin: Warm, intact, erythema, ecchymosis to Right lateral ankle

Diagnostic results:

The Ottawa ankle rules: The Ottawa ankle rules (OAR) are clinical decision guidelines used to identify whether patients with ankle injuries need to undergo radiography (Wang et al., 2013). This measure has been applied to reduce redundant radiographs and expenses. The OAR has proven to be a highly sensitive and modestly specific test for fractures associated with ankle injuries (Wang et al., 2013). There must be pain in the malleolar zone and one of the following: bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus; bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus or inability to bear weight for four steps both immediately after the injury and in the emergency department (Ball et al., 2017, p.546).
Anterior drawer test: The clinician performs the test by manually applying an anteriorly directed force at the calcaneus or a backward push on the tibia and attempting to discern pathological talocrural joint laxity from normal physiological laxity (Croy et al., 2013). This test is used to routinely examine talocrural joint integrity to identify the severity of anterior talocrural joint laxity in the acute setting(Croy et al., 2013).
X-ray of right ankle standard series: Radiographic examinations of the ankle are important in the clinical management of ankle injuries in hospital emergency departments (Eastgate et al., 2014, Para 1). Patients who are classified as positive by the OAR, are considered to require a series of standard ankle radiographs to confirm the diagnosis (Wang et al., 2013).

25-hydroxy vitamin D: Fragility fractures may result from chronic vitamin D deficiency leading to osteoporosis (Sizar, Khare, Goyal, Bansal, & Gigler, 2020).

Bone density test: Fragility fractures may result from chronic vitamin D deficiency leading to osteoporosis (Sizar, Khare, Goyal, Bansal, & Gigler, 2020).

Differential Diagnoses

Lateral ligament complex injury: ankle sprains involve an injury to the ATFL and CFL andare the most common reason for missed athletic participation (Macknet & Weatherford, 2020). Symptoms pain with weight-bearing (may or may not be able to bear weight), swelling and ecchymosis, recurrent instability, catching or popping sensation may occur following recurrent sprains(Macknet & Weatherford, 2020). Ecchymosis and swelling noted to right lateral ankle, patient reports ‘pop’ sensation at the time of injury. Pain to right ankle with weight-bearing
Stress fractures to the distal fibula or cuboid bone: On physical examination, there is the hallmark localized point tenderness on the lateral foot, especially in the area of the cuboid bone. There may also be some mild erythema and subtle soft tissue swelling over the lateral foot area(Lau & Dreyer, 2020). Soft tissue swelling and erythema noted to right lateral ankle
Ankle sprain: Athletes and nonathletes share this similar injury most often as a result of soft tissue injury with symptoms that include pain, swelling, bruising, and damage (“Soft Tissue Injury”, n.d.)
Achilles tendon rupture: Despite being the strongest and thickest tendon in the body, the Achilles tendon is the most common to rupture (Egger & Berkowitz, 2017). Achilles tendon ruptures most commonly occur in a healthy, active, young- to middle-aged population(Egger & Berkowitz, 2017). Immediate pain is present but gradually dissipates, leaving a patient to complain of difficulty with plantar flexion, weight-bearing, or a limp (Egger & Berkowitz, 2017). The patient is 46 years old, fairly healthy, active, reports immediate pain to the right ankle while playing soccer, able to bear weight but uncomfortable.
Tarsal Navicular Fracture: Fractures of the tarsal navicular bone are most commonly the result of either traumatic injury or undue stress (Gheewala, Arain, & Rosenbaum, 2019). Patients who have endured a navicular body fracture present with a profound degree of swelling on the dorsal and medial aspects of the foot, all of which is due to the mechanism of the injury and disruption of the medial column of the foot (Gheewala, Arain, & Rosenbaum, 2019).

The practitioner should also investigate menstrual history in females, nutrition (to include calcium and vitamin D intake), medications, footwear, and special equipment used (especially in a sport such as a triathlon) (Lau & Dreyer, 2020)

References
Ball,J.W., Dains,J.E., Flynn,J.A., Solomon,B.S., & Stewart,R.W. (2017). Seidel’s guide to physical examination – E-book: An interprofessional approach. Elsevier Health Sciences.
Croy,T., Koppenhaver,S., Saliba,S., & Hertel,J. (2013). Anterior Talocrural joint laxity: Diagnostic accuracy of the anterior drawer test of the ankle. Journal of Orthopaedic & Sports Physical Therapy, 43(12), 911-919.
https://doi.org/10.2519/jospt.2013.4679

Eastgate,P., Davidson,R., & McPhail,S.M. (2014). Radiographic imaging for traumatic ankle injuries: A demand profile and investigation of radiological reporting timeframes from an Australian tertiary facility. Journal of Foot and Ankle Research, 7(1).
https://doi.org/10.1186/1757-1146-7-25

Egger, A. C., & Berkowitz, M. J. (2017). Achilles tendon injuries.
Current reviews in musculoskeletal medicine,
10(1), 7280. https://doi.org/10.1007/s12178-017-9386-7

Lau, H., & Dreyer, M. A. (2020, July 07). Cuboid Stress Fractures. Retrieved July 22, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK542250/
Gheewala, R., Arain, A., & Rosenbaum, A. J. (2019, June 01). Tarsal Navicular Fractures. Retrieved July 22, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK542221/
Macknet, D., & Weatherford, B. (n.d.). Ankle Sprain. Retrieved July 22, 2020, from https://www.orthobullets.com/foot-and-ankle/7028/ankle-sprain
Soft-Tissue Injuries. (n.d.). Retrieved July 22, 2020, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/softtissue-injuries
Wang,X., Chang,S., Yu,G., & Rao,Z. (2013). Clinical value of the Ottawa ankle rules for diagnosis of fractures in acute ankle injuries.
PLoS ONE,
8(4), e63228.
https://doi.org/10.1371/journal.pone.0063228 NURS 6512: Advanced Health Assessment and Diagnostic Reasoning
Week Eight: Assessment of the Musculoskeletal System
Case study #2: Ankle Pain
Scenario: KC 46-year-old African American female present with reports of pain to both ankles,
states shes more concerned about her right ankle. She was playing soccer over the weekend and
heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the
ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What
other symptoms need to be explored? What are your differential diagnoses for ankle pain? What
physical examination will you perform? What special maneuvers will you perform? Should you
apply the Ottowa ankle rules to determine if you need additional testing?
Episodic/Focused SOAP Note for Throat Exam
Patient Information: K.C. Age: 46 Y/O. Sex: Female DOB: 3/6/1972
S.
Chief Complaint: Having pain to both my ankles but more severe the right.
History of Present Illness:
K.C. is a 46-year-old African American female who presented pain to her bilateral ankle for the
past 2 days. Patient reported while playing soccer this past weekend she heard a pop sound
during the game. The pain appears to be worse on to her right ankle, she is able to bear weight on
both ankles but states having more pain and discomfort to her right ankle when walking or
standing. Patient been applying cold compress which provides some relief, she now noticed
increased swelling to her bilateral ankles more so to her right ankle.
Current Medications:
Tylenol ES 500mg 2tabs BID as needed
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Multivitamins one tablet daily
Allergies: Nuts-hives
Immunization History: Flu Vaccine September 2017
Past Medical History (PMH):
Fam Hx: Reported both parents are healthy and alive. Father has hypertension.
Personal/Social History: Patient is single. Works as a physical education teacher fulltime. Does not smoke, drink or use any illicit drugs. Physically active, exercises 5-6 time
a week.
Review of Systems:
Constitutional: A&O x4, pleasant and cooperative. No acute distress. Denies weight loss,
weakness, or fatigue.
HEENT: Denies headache, sore throat or changes in vision and hearing.
SKIN: No rash or itching.
CARDIOVASCULAR: Denies chest pain or palpitations.
RESPIRATORY: Denies shortness of breath or cough.
GASTROINTESTINAL: Denies abdominal discomfort. Reported having regular daily
bowel pattern.
GENITOURINARY: Bilateral ankle pain for the past 48 hours, more severe on right
ranging 4-5/10. Swelling started past 24 hours. Able to bear weight but with discomfort.
NEUROLOGICAL: Denies focal loss of strength or loss of sensation.
MUSCULOSKELETAL: Denies focal weakness, facial droop, or joint swelling.
HEMATOLOGIC: Diagnosed with anemia 2 years ago. Regularly checked by her
primary care physician and managed by prescribed supplements. No bleeding or bruising.
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LYMPHATICS: No enlarged nodes. No cervical lymphadenopathy
O.
Physical exam: Vital signs: B/P 126/72, Pulse 68 (strong and regular); Temp 98.0F orally;
RR 19; non-labored; SpO2: 98% room air;
Height: 5′ 4″ Weight:122 lbs.
General: A&O x4, pleasant and cooperative. Not in any acute distress.
HEENT: Normocephalic and atraumatic. Sclera anicteric, No conjunctival erythema,
PERRLA. Oropharynx red. No lesions. Moist mucous membranes.
Neck: Supple. No JVD. Trachea midline. No pain, swelling or palpable nodules.
Chest/Lungs: Clear to auscultation bilaterally. No accessory muscle use.
Heart/Peripheral Vascular: Right ankle swelling. Regular rate and rhythm noted. No
murmurs. No palpitation. No clubbing or cyanosis; Normal capillary refill. Bilateral equal
pedal pulses.
ABD: Soft, nontender, nondistended. No rigidity, rebound, or guarding. No palpable
hepatosplenomegaly.
Genital/Rectal: continent of bladder and bowel.
Musculoskeletal: Lower extremities with reports of pain. Right ankle swelling and
2×1.5cm ecchymosis on mid-lateral malleolus area with tenderness upon palpation on the
lateral side of the ankle over the anterior talofibular ligament (ATFL). Range of motion
with pain and limitation on dorsiflexion, plantar flexion, and inversion. Skin intact. Able
to bear weight on BLE, with discomforts on the right ankle. No bony tenderness,
deformity or crepitus present.
Neuro: Alert and oriented x4. Strength and sensation intact.
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Skin/Lymph Nodes: 2×1.5cm ecchymosis on mid-lateral malleolus area of the right ankle.
Intact skin. No cervical lymphadenopathy. No rashes, or erythema. No lesions.
Diagnostic studies:
Anterior Drawer Test: positive
An Anterior Drawer Test is considered as a screening test in the assessment of lateral
ankle sprain and suspected ATFL injury (Croy, Hertel, Koppenhaver, & Saliba, 2013).
Inversion test: pain noted in the area of anterior talofibular ligament.
Imaging Studies:
Right ankle X-ray
– According to the rule, an ankle X-Ray series is only required if there is any pain in the
malleolar zone plus one of the following: bone tenderness along the distal 6cm of the
posterior edge of the fibula or tip of the lateral malleolus bone tenderness along the distal
6cm of the posterior edge or tip of the medial malleolus or an inability to bear weight
both immediately and in the emergency department for four steps (Ball, Dains, Flynn,
Solomon, & Stewart, 2015, p. 252).
A.
Differential Diagnoses (DD):
Grade 2 Lateral Ankle Sprain: Sports injuries occur when running, cutting, landing from a
jump, or from direct contact which can produce an audible tear or pop causing pain and swelling
that are immediate, but ecchymosis may lag a day or two behind (American Orthopaedic Foot &
Ankle Society, 2015).
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– An ankle sprain is an injury to one or more ligaments in the ankle with symptoms
such as pain, swelling, soreness, bruising, difficulty walking, and joint stiffness
(American College of Foot and Ankle Surgeons, 2018).
– Based on the reported symptoms and physical assessment findings, ankle sprain is the
primary diagnosis for the patient. Anteroposterior lateral views x-ray preferably with
weight bearing or during inversion will reveal extent of ligament injury.
Achilles tendinitis inflammation of the Achilles tendon producing symptoms of pain and
swelling where the tendon inserts into the calcaneus, and patient reports of feeling of tightness
that makes walking and running difficult (Baumann, Dains, & Scheibel, 2016, p. 269).
– The area of pain and tenderness noted with G.M. involves mid-lateral area of the
ankle. Swelling of the Achilles tendon can be assessed in the posterior part of the
ankle.
Ankle fracture: may involve the one or more of the ankle bones such as tibia, fibula, and talus
with symptoms such as severe immediate pain, swelling, bruising, tenderness, deformity, and
inability to bear weight (American Academy of Orthopaedic Surgeons, 2013).
Anterior impingement: which is also known as footballers ankle with presenting symptoms
such as pain and inflammation including decrease in overall ankle range of motion, mostly
affecting dorsiflexion (Stanford Health Care, 2017).
Plantar fasciitis: affect women twice as often as men, is caused by chronic weight-bearing
stress when laxity of foot structures allows the talus to slide forward and medially, calcaneus to
drop, and plantar ligaments and fascia to stretch (Baumann, Dains, & Scheibel, 2016, p. 269).
Pain is worse on awakening and is relieved with non-weight bearing activity often involving the
heel (Baumann, Dains, & Scheibel, 2016, p. 269).
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Reference
American Academy of Orthopaedic Surgeons. (2013). Ankle Fractures. Retrieved from
https://orthoinfo.aaos.org/en/diseases–conditions/ankle-fractures-broken-ankle/
American College of Foot and Ankle Surgeons. (2018). Ankle Sprain. Retrieved from
https://www.foothealthfacts.org/conditions/ankle-sprain
American Orthopaedic Foot & Ankle Society. (2015, June). Ankle Sprain. Retrieved from
http://www.aofas.org/PRC/conditions/Pages/Conditions/Ankle-Sprain.aspx
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to
physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Baumann, L. C., Dains, J. E., & Scheibel, P. (2016). Advanced health assessment and clinical
diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby