A 19-year-old female presented to the emergency department with acute right ankle pain and inability to bear weight after falling while dancing in high heel shoes. She was otherwise healthy, with no pertinent past medical history. She endorsed pain primarily along the posterior aspect of her right ankle and lower calf. Physical exam of the right ankle was notable for no bony deformity, tenderness along the posterior ankle and distal calf, inability to actively plantarflex the right foot.

Given the patient’s presenting complaints and constellation of physical exam findings, the emergency physician performed a bedside ultrasound, confirming the suspected diagnosis. The first clip below is the normal side, the second clip is the affected side.