Anteromedial impingement of the ankle

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

Epidemiology

It is one of the less common ankle impingement syndromes . 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 .

Clinical presentation

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

Pathology

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 .

Radiographic features

Plain radiograph/CT

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

US

Synovial lesions and premalleolar hyperemia on color Doppler .

MRI

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

Treatment and prognosis

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

Differential diagnosis

See also