Posterior ankle impingement (os trigonum) syndrome

Case contributed by Ali Abougazia
Diagnosis almost certain

Presentation

Posteromedial ankle pain in a swimmer.

Patient Data

Age: 25 years
Gender: Male
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial
T1
This study is a stack
Coronal
T2
This study is a stack
Sagittal
T1
This study is a stack
Sagittal
STIR
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Info

An os trigonum is seen with alteration of its marrow signal, being of low T1 and high T2 / STIR (bone marrow edema/contusion), as well as surrounding soft tissue edema signal. Similar marrow signal changes are seen within the posterior talar aspect. Mild amount of tibiotalar and sub-talar joint effusion is noted.

Case Discussion

In light of patient's history, the above described changes are suggestive of posterior ankle impingement (os trigonum) syndrome with tibiotalar and sub-talar joint effusion.

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