OK, but I just read the exact opposite on a reputable site.
Those who sustain high ankle sprains usually present with pain in the outside-front of the leg above the ankle, with increased discomfort when twisting (external rotation) is applied. In some cases, the diagnosis is only made after treatment for the more common, lateral, ankle sprain fails.
[2] Diagnosis may also be delayed because swelling is usually minor or nonexistent and the true nature of the injury unappreciated.
[3] A variety of diagnostic tests have been described such as the '
squeeze' (compressing the tibia and fibula above the midpoint of the calf), '
dorsiflexion with compression' (patient dorsiflexes the foot while the examiner compresses the internal and external malleolus), and '
external rotation' (patient sits with leg dangling and ankle at 90° and external rotation then applied to the foot) etc. None of them performs sufficiently well to allow diagnosis to be made on the basis of a single test,
[4] and is usually made by combining multiple tests supplemented with appropriate imaging when indicated.
Plain radiographs,
Ultrasound[5] or
MRI may be used for diagnosis.
In the case of
X-rays, demonstration of widening of the
tibia and
fibula 'mortise', a fracture of the
medial malleolus, or a
Maisonneuve fracture, will indicate an unstable or potentially unstable injury. However, 'normal' x-rays do not exclude significant ligament injury, and in one study, the ratio of diagnostic X-ray to known syndesmotic injury was only one in 17. By contrast, ultrasound may permit the injury to be visualized while the mortise is being stressed.
[5] Consequently, a diagnostic modality such as ultrasound or magnetic resonance imaging (MRI)
[4] that demonstrates the ligament itself may be helpful, if clinical suspicion remains.
[ from wikipedia]
Answered my own ??.
