Posterior ankle impingement syndrome

Case contributed by Varun Babu
Diagnosis certain


Recurrent ankle sprain last two weeks.

Patient Data

Age: 50 years
Gender: Female

A 5 mm loose body is seen inferior to the fibula in the lateral recess of the ankle joint.  Another 12x4 mm sized loose body is seen in the anterior recess.

Elongated lateral tubercle of talus (Steida process) shows T1 hypointense and T2 hyperintense signals surrounded by edema in the retrocalcaneal bursa.

There is associated fluid pocket measuring 2.8 cm long 1.5 cm thick around the tendon sheath of flexor hallucis longus which appears intact.

Case Discussion

Imaging features point to a Steida process causing secondary posterior ankle impingement syndrome, with accompanying tenosynovitis of flexor hallucis longus.

Osteodegenerative changes of the talar joint with loose bodies in the anterior and lateral recesses.

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