Ankle sprain can present with ankle joint swelling, pain, dyskinesia and other manifestations, and its differential diagnosis includes ankle fracture and ankle ligament rupture. 1. Ankle fracture: ankle fracture and ankle sprain have the same point in the mechanism of injury, which can cause fracture structure destruction in the mechanism of trauma, resulting in ankle pain, swelling, deformity, activity disorder and other manifestations. X-ray and CT examination of the ankle joint can clarify the fracture situation, and then distinguish it from ankle sprain. 2. Rupture of ankle ligaments: Large ankle sprains, such as inversion, eversion or the transmission of rotational force can cause rupture of the medial collateral ligament, lateral collateral ligament or inferior tibiofibular ligament of the ankle joint, which can lead to ankle joint swelling, pain, impaired mobility and other manifestations. MRI examination of the ankle joint can clarify the ligament damage, and then distinguish it from ankle sprain. It is recommended to actively seek medical advice and follow the doctor’s instructions for examination and treatment.