Posterior ankle impingement

Case contributed by Mansi S
Diagnosis almost certain

Presentation

Non-traumatic right ankle pain for 1 year.

Patient Data

Age: 40 years
Gender: Male
mri

Increased PDFS signal in the posterior talar process suggestive of marrow edema. Fluid signal intensity is noted along the flexor hallucis longus tendon suggestive of tenosynovitis. There is mild synovial thickening along the inferior tibiofibular joint and talofibular joint suggestive of synovitis. There are well-defined multiloculated T2 hyperintense lesions showing fluid signal intensity noted along the posterior joint recess. Subarticular cystic changes are noted along the neck of the talus and are likely degenerative changes. A plantar spur is noted along the inferior surface of the calcaneum with mildly increased signal in the overlying plantar fascia. The Achilles tendon is normal.

These findings are suggestive of posterior ankle impingement syndrome.

Case Discussion

Posterior ankle impingement occurs from repetitive ankle plantar flexion leading to soft tissue compression, synovitis, capsulitis and eventually scarring.

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