Anteromedial impingement of the ankle

Last revised by Dr Joachim Feger on 16 Sep 2021

Anteromedial impingement of the ankle is one of the ankle impingement syndromes and can occur as a late effect of a traumatic injury 1-3.

It is one of the less common ankle impingement syndromes 2. It can occur as a result of a previous plantar flexion and inversion injury and can be seen in football players, cross-county runners and dancers 1.

Usually, patients complain of pain or clicking associated with dorsiflexion and inversion 1-3.

Anteromedial ankle impingement can occur as a consequence of anterior tibiotalar ligament injury with subsequent synovitis, osteophyte formation from repetitive microtrauma, fractures and/or chronic ankle instability causing mechanical entrapment of the anteromedial part of the tibiotalar joint capsule 1-4.

Bony proliferation and osteophytic spurs can be seen at the anteromedial tibial plafond and at the medial malleolus 1, which can be better seen on lateral ankle radiograph or sagittal view on CT.

Synovial lesions and premalleolar hyperemia on color Doppler 3.

Soft tissue thickening can be seen at the anteromedial aspect of the tibiotalar joint with signs of synovitis and osteophyte formation 1. Possible associated bone marrow edema in the medial malleolus and medial talus.

Conservative treatment seems to be controversial, and definitive treatment is usually surgical or arthroscopically 1.

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