Presentation
Footballer with chronic painful mechanical limitation of movement of the right ankle for six months which worsens by running and standing for long periods.
Patient Data
Anterior ankle impingement syndrome by an osteophyte; there are small dorsal tibial osteophytes and Stieda's process with mild bone marrow edema and modest joint effusion. Edema of the anterior and posterior portions of the distal tibia is reported. There is subtle medullary edema of the articular surface of the talus and lateral malleolus with effusion in the synovial sheath of the tendons of the flexor hallucis longus and flexor digitorum longus, both normal. Mild edema and thickening of the posterior talofibular ligament.
Case Discussion
Ankle impingement is the entrapment of an anatomical structure with pain and functional limitation of the ankle and manifests itself with the most common sign which is bone marrow edema.
Posterior ankle impingement syndrome usually is secondary to repeated or acute forced plantar flexion of the foot. Posterior ankle impingement is common in dancers and soccer players.
Anterior ankle impingement syndrome is due to the formation of anterior tibiotalar spurs with a painful limitation of ankle dorsiflexion. Anterior ankle impingement is associated with chondral fraying, synovitis in the anterior capsular recess, modest reduction of joint space and sometimes osteochondral loose bodies. Anterior impingement occurs due to repeated stress in ankle dorsiflexion.
Radiographer: TSRM Fabio Imola
Radiographer: TSRM Nunzio Bianco
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