My boyfriend hurt his ankle, we thought it was just a small sprain but when he put pressure on it he could feel the pain in his upper foot and shin.

Ankle sprain/fractur: When sprained ankles come in the ed docs use the ottawa ankle rules to decide who gets an x-ray and who doesn't. It isn't yet common practice but it makes sense to me to say if you don't need an x-ray according to these rules you don't need an er visit. The wiki page on ottawa ankle rules is accurate. Bad sprains can take months to get better and sometimes hurt so bad i've put on soft casts.

Visit a specialist : He needs to be seen by a specialist in foot and ankle.

Ankle: Needs to get it checked at minimum an MRI and x-ray. Advised to stay off it use rest ice compression and elevation. Always possibility off fracture, torn ligament or nerve damage.

X-ray: You will need and x-ray to see if you have a fracture. If fractured, you will need to be immobilized with a splint, cast, or rigid walking boot depending on the location of the injury. You may need surgery if the fracture is not stable or is displaced. Have you physician determine which course of treatment is best for you.