Ankle Impingement Syndromes

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Acute or repetitive trauma to the ankle can result in painful restriction of movement caused by impingement of soft tissue and osseous structures. Ankle impingement syndromes are classified according to their anatomic relationship to the tibiotalar joint. This article reviews the relevant anatomy, etiology, and clinical features of ankle impingement syndromes, and demonstrates the potential imaging findings and discusses management of each for these conditions.

Section snippets

Anterior impingement syndrome

Anterior impingement is a relatively common cause of chronic ankle pain seen particularly in such athletes as ballet dancers and soccer players.4, 5, 6 Symptoms are generally progressive and are caused by impingement of hypertrophied soft tissue and bony spurs within the anterior ankle joint.

Anterolateral impingement

Anterolateral impingement is a relatively uncommon cause of anterolateral ankle pain caused by entrapment of hypertrophied soft tissues within the anterolateral recess of the ankle.

Anteromedial impingement

An uncommon cause of chronic ankle pain, anteromedial impingement rarely occurs as an isolated finding.36, 37

Posteromedial impingement

Until recently posteromedial impingement was one of the least described ankle impingement syndromes and accordingly its etiology was less well understood. Although there are few reported series they have identified relatively characteristic imaging findings.

Posterior impingement

Posterior impingement syndrome encompasses a group of pathologies that are characterized by posterior ankle pain in plantar flexion. Symptoms result from compression of the talus and soft tissues between the posterior tibia and calcaneum. Other terms, such as “os trigonum syndrome,” “talar compression syndrome,” and “posterior block,” have also been used to describe the same collection of signs and symptoms. Posterior ankle pain is a common symptom and may be caused by a range of soft tissue

Summary

The ankle impingement syndromes are an established cause of ankle dysfunction within the general population and within the athletic community. In many cases the diagnosis is clinical, although imaging has a significant role to play particularly in the exclusion of alternative or concomitant pathology or when the diagnosis is in doubt. For most patients conservative management or nonsurgical intervention allows resumption of their previous level of activity, even in elite athletes. Surgical

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