Sprain (Overview)

Diagnosis

Information about exactly how you injured your joint is an important part of your evaluation. This information includes:

• The type of movement that caused your injury

• How long it took for pain and swelling to appear

• The ability to use the joint since the injury (for example, ability to bear weight)

• Changes in joint function, especially joint instability or a decrease in the joint's normal range of motion

Also, as part of your basic evaluation, your health care professional will ask you about your occupation, your routine recreational and sports activities, and any history of previous injuries to the injured joint. This will help to determine your risk of injuring the area again.

If you were injured during an athletic activity, your doctor may want your coach or trainer to provide an eyewitness account of your injury.

Since most joints come in pairs, your health care professional will examine you, comparing your injured joint with your uninjured one. During the examination, your doctor will check your injured joint for signs of swelling, deformity, tenderness, bruising and surface skin injuries. If pain and swelling permit it, he or she also will evaluate your joint's range of motion, and perform special maneuvers to check for joint instability and abnormal looseness. If your injury is severe, your doctor may recommend diagnostic tests, including:

• X-rays to check for a fracture or other bone damage

• A magnetic resonance imaging (MRI) or computed tomography (CT) scan to look for torn cartilage or another cause of pain

• Arthroscopy, a minor operation, to look inside the joint and examine it directly

Once your physical examination and any recommended testing are complete, your doctor may gauge the severity of your sprain according to a traditional grading system.

• Grade I - A mild injury that causes only stretching or microscopic tears in a ligament. Although these tiny tears can stretch the ligament, they do not significantly affect the stability of the injured joint.

• Grade II (moderate) - The injured ligament is partially torn, and there is some mild to moderate joint instability.

• Grade III (severe) - The ligament is either torn completely or avulsed (pulled away from the place where it attaches to bone), and there is significant joint instability.