Anterior ankle impingement syndrome

Last revised by Henry Knipe on 15 Sep 2021

Anterior ankle impingement (AAI) syndrome is the result of chronic repetitive trauma with impingement of the anterior tibia against the talus.

Common in soccer players and ballet dancers 1.

Clinical features of anterior ankle impingement syndrome include painful and limited dorsiflexion and anterior joint line swelling 2. Anterior impingement can occur after severe previous ankle sprain or repeated weight bearing activities with ensuing thickening of the injured ligaments, resulting in their impingement between the anterior inferior tibia and the talus.

Chronic repetitive trauma from impingement of anterior tibia and talus leads to osteophytic spur formation at the anterior tibial margin and the corresponding talus - tibiotalar spur

Anterior ankle impingement is best appreciated on lateral ankle radiograph or sagittal view on CT. Some advocate to the use of oblique radiographs to assess if bony spurring is medial or lateral 5.

T2 fat sat or STIR sagittal images can be useful for demonstrating marrow edema, subchondral changes and synovial/soft tissue thickening.

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: tibiotalar spurs
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