Diagnosis and Classification

Injuries to the ankle joint often display specific characteristics on x-ray that your doctor can use to determine the extent of injury. Images of both ankles may be taken for comparison. First and foremost, an x-ray of the ankle can determine presence of fracture. Second, by placing the foot in specific positions and measuring the space and angles between bones on x-ray, the doctor can assess which ligaments are likely involved.

Classification systems provide doctors and patients with an understanding of the severity of an injury. Leach’s classification of ankle sprains (first described back in 1979) is based on the appearance and amount of ankle joint function retained [12]. A grade I injury presents with minimal loss of function, local tenderness and mild swelling. Grade II injuries are characterized by the patient experiencing difficulty with weight bearing, moderate swelling and diffuse tenderness. Grade III injuries represent the most severe form of ankle sprain and include significant functional disability with minimal ability to bear weight accompanied by severe swelling, bruising and tenderness. As the degree of injury increases, the time to rehabilitate from the injury also tends to increase.