luda 在相册里
踝关节扭伤了
Doctor Examination
物理演示。
your doctor will diagnose your ankle sprain by performing a careful examination of your foot and ankle . this physical exam may be painful .
pal pate . Your doctor will gently press around the ankle to determine which ligaments are injured . range of motion . he or she may also move However，
to diagnose a sprain，your doctor will gently pal pate around the outside of the ankle in the area of the pain(arrow)
医生检查
体格检查
医生通过仔细检查脚和踝关节来诊断脚踝扭伤。检查过程可能会很痛。
- 触诊 医生将轻轻按压脚踝，以确定哪些韧带受伤。
- 活动范围 沿不同方向移动脚踝； 由于脚踝僵硬，肿胀通常活动范围不会很大。
如果没有骨折，医生可以根据肿胀、疼痛和瘀伤的程度来判断脚踝扭伤的严重程度。
Imaging Tests
X-rays. X-rays provide images of dense structures, such as bone. Your doctor may order x-rays to rule out a broken bone in your ankle or foot. A broken bone can cause similar symptoms of pain and swelling.
Stress x-rays. In addition to plain x-rays, your doctor may also order stress x-rays. These scans are taken while the ankle is being pushed in different directions. Stress x-rays help to show whether the ankle is moving abnormally because of injured ligaments.
Magnetic resonance imaging (MRI) scan. Your doctor may order an MRI if he or she suspects a very severe injury to the ligaments, damage to the cartilage or bone of the joint surface, a small bone chip, or another problem. The MRI may not be ordered until after the period of swelling and bruising resolves.
Ultrasound. This imaging scan allows your doctor to observe the ligament directly while he or she moves your ankle. This helps your doctor to determine how much stability the ligament provides.
影像检查
- X光片 X射线可提供致密结构（例如骨骼）的图像。医生进行X光检查以排除脚踝或脚部骨折的情况。 因为骨折会引起类似的疼痛和肿胀症状。
- 应力X射线 除了普通X射线外，还可进行应力X射线检查。在脚踝向不同方向推动时进行X线检查。应力X射线有助于显示踝关节是否由于受伤的韧带而引起运动异常。
- 磁共振成像（MRI）扫描 如果怀疑韧带受到严重损伤，关节面的软骨或骨骼损伤，或者有小碎骨片或其他问题，可进行MRI检查。 一般在肿胀和瘀伤消退后，方可进行核磁共振检查。
- 超声检查 这种检查可在移动脚踝时直接观察韧带。帮助医生判断韧带的稳定性。
Grades of Ankle Sprains
After the examination, your doctor will determine the grade of your sprain to help develop a treatment plan. Sprains are graded based on how much damage has occurred to the ligaments.
Grade 1 Sprain (Mild)
- Slight stretching and microscopic tearing of the ligament fibers
- Mild tenderness and swelling around the ankle
Grade 2 Sprain (Moderate)
- Partial tearing of the ligament
- Moderate tenderness and swelling around the ankle
- If the doctor moves the ankle in certain ways, there is an abnormal looseness of the ankle joint
Grade 3 Sprain (Severe)
- Complete tear of the ligament
- Significant tenderness and swelling around the ankle
- If the doctor pulls or pushes on the ankle joint in certain movements, substantial instability occurs
In a Grade 2 sprain, some but not all of the ligament fibers are torn. Moderate swelling and bruising above and below the ankle joint are common.在2级扭伤中，部分韧带纤维被撕裂。踝关节上方和下方的中度肿胀和瘀伤很常见。
踝关节扭伤分级
检查后，医生会确定扭伤的分级，来制定治疗计划。扭伤是根据韧带的损伤程度来分级的。
1级扭伤(轻度)
- 韧带纤维轻微拉伸和细微撕裂
- 脚踝周围有轻微的压痛和肿胀
2级扭伤(中度)
- 韧带部分撕裂
- 脚踝周围有中度压痛和肿胀
- 如果医生以某种方式移动踝关节，会出现异常的松动
3级扭伤(严重)
- 完全撕裂韧带
- 脚踝周围有明显的压痛和肿胀
- 如果医生拉动或推动踝关节，会发生严重的不稳定