Suspect where an ankle sprain takes a long time to settle down. Perform the squeeze test (compress upper tib/fib and distal pain occurs, Fig. 8) or abduction/external rotation tests (hold upper tib/fib and externally rotate/abduct ankle to reproduce pain) and check a mortise view (Fig.9) X-ray (>1mm reduction in the medial clear space AB or <10mm tibio fibular overlap CD). Late x-rays show calcification of the ligaments.