In the ED, their vitals/exam are as above. Differential includes partial/complete Achilles tendon rupture, partial/complete calf tear including plantaris rupture. Lower concern for bruise, dislocation, fracture given no direct trauma. Lower suspicion for concern for DVT given trauma and lack of risk factors. No concern for osteo vs. cellulitis on exam today.
– Labs/Tests: None
– Imaging: BSUS of calf/achilles looking for hypoechoic area/discontinuity suggestive of tendon rupture
– Treatments: Pain control as necessary including Motrin/Tylenol/as needed oxycodone
– Consults: None
– Dispo: Likely discharge with crutches and in short leg splint in equinus (ankle plantar flexed to 20-30 degrees, can facilitate by having hang leg off table while sitting up) if BSUS positive vs. aircast boot (if BSUS negative) with plan for RICE treatment and sports medicine follow-up for likely MRI