A 40-year-old woman presented to the emergency department (ED), complaining of severe left ankle pain. She stated that just before arrival, she twisted her ankle and then fell to the ground. She had no medical history and had no previous injuries to the affected ankle. On physical examination, she had a significant amount of swelling around her ankle. She had tenderness to palpation over her medial malleolus, as well as her proximal fibula. Radiographs were performed in the ED.
