Examine for ecchymoses, abrasions, or swelling
Vascular and neurologic assessment
DP and PT pulses
4 sensation distributions: saphenous nerve (medial mal), superficial fib (lat mal), sural nerve (lateral 5th digit), deep fib (1st web space)
Note skin integrity and areas of tenderness or crepitus over ankle
Range joint passively and actively to evaluate for stability
Examine joints above and below the ankle
Perform anterior drawer test (positive exam suggests torn ATFL)
Always palpate entire length of fibula to rule-out Maisonneuve Fracture (fibulotibialis ligament tear)
Perform a crossed-leg test to detect syndesmotic injury
Evaluate integrity of Achilles tendon (Thompson test)
Palpate midfoot and base of 5th metatarsal for tenderness
DP and PT pulses
4 sensation distributions: saphenous nerve (medial mal), superficial fib (lat mal), sural nerve (lateral 5th digit), deep fib (1st web space)
Perform a crossed-leg test to detect syndesmotic injury
Ankle fracture
Ankle sprain
Humerus fracture
Ankle dislocation
Femur fracture 
Ankle syndesmosis injury
Femur fracture
Radiograph-negative ankle injury 