skip to main content

Ankle sprain not requiring radiography — RCPSC EM MCQ

Instant feedback + full explanation. One question, done properly.

HardMusculoskeletalAnkle sprain not requiring radiographyRCPSC EM

After tibial fracture fixation, a patient has escalating analgesic requirements, pain on passive toe extension and a tense calf. Diastolic BP is 62 mmHg and compartment pressure is 38 mmHg; pedal pulses remain palpable. What is the next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Release external constriction and obtain immediate surgical fasciotomy assessment

Explanation lettering: D = shown as A · E = shown as B · B = shown as D · A = shown as E

C is correct: the delta pressure is 24 mmHg and the examination is concerning for acute compartment syndrome; pulses commonly persist. D falsely relies on pulses. E may reduce arterial inflow. A postpones decompression for a different diagnosis. B increases external pressure.

Reference: Emergency Care BC, Acute Compartment Syndrome: https://emergencycarebc.ca/clinical_resource/clinical-summary/acute-compartment-syndrome/