Os trigonum Syndrom
Combined
anterior and posterior ankle impingement syndrome with nonunion of Cedell fracture in a 58-year-old female: a case report. The radiographs of right ankle. a Anteroposterior weight-bearing view showing abundant osteophytes below the medial malleolus (arrowhead).b Lateral weight-bearing view showing osteophytes on the dorsal talar neck (white short arrow), anterior tibial plafond (white short arrow), posterior talar process (black short arrow), and the PMTT fracture fragment (star) with preservation of the tibiotalar joint space. c, Valgus stress view showing a talar tilt of 13° angle
Combined
anterior and posterior ankle impingement syndrome with nonunion of Cedell fracture in a 58-year-old female: a case report. CT scans. a coronal view showing a nondisplaced, nonunited PMTT fracture fragment (star) and an interface between the fracture fragment and the parent talus (long arrow). b sagittal view showing the anterior and posterior osteophytes of impingement (white and black short arrow). c axial view showing the larger posterolateral tubercle osteophyte (black short arrow), the nonunited PMTT fragment (star) and the interface (long arrow)
Combined
anterior and posterior ankle impingement syndrome with nonunion of Cedell fracture in a 58-year-old female: a case report. MRI sagittal PDWI showing the anterior, posterior ankle joint effusion (long arrow) and the “Kissing contusions (sun)” on the posterior aspect of the posterior subtalar articulation
Ankle
impingement. A T2-weighted MRI with reactive edema surrounding an os trigonum
Posterior
ankle impingement syndrome • Posterior ankle impingement - illustration of causes - Ganzer Fall bei Radiopaedia
Posterior
ankle impingement syndrome • Posterior ankle impingement (os trigonum) syndrome - Ganzer Fall bei Radiopaedia
Posterior
ankle impingement syndrome • Os trigonum syndrome - Ganzer Fall bei Radiopaedia
Posterior
ankle impingement syndrome • Posterior ankle impingement (Os trigonum syndrome) - Ganzer Fall bei Radiopaedia
Posterior
ankle impingement syndrome • Os trigonum syndrome - Ganzer Fall bei Radiopaedia
nicht verwechseln mit: Trigonum Syndrom (Seitenventrikel)Posterior ankle impingement (PAI) syndrome is one of the impingement syndromes involving the ankle. It is classically described in ballet dancers.
Epidemiology
It is usually a unilateral phenomenon. Bilateral posterior ankle impingement syndrome has been described but is rare .
Clinical presentation
Patients usually present with a sharp pain at the back of the ankle upon plantar flexion. The pain might persist for some time after such a movement.
Pathology
Thought to occur from repetitive ankle plantar flexion leading to soft tissue compression, synovitis, capsulitis and eventually scarring .
Predisposing anatomical factors
- Stieda process
- os trigonum
- fracture involving lateral tubercle of the posterior process of the talus
- prominent superior surface of calcaneal tuberosity
- prominent downslope of the posterior tibial articular surface
- any abnormal calcification/ossification posterior to the ankle
Radiographic features
MRI
- may demonstrate posterolateral capsular thickening and synovitis involving an intact posterior talofibular ligament (PTFL)
- there may be tenosynovitis involving the flexor hallucis longus (FHL)
- may show one or more of the predisposing anatomical factors
- accompanying bone contusion may be present, involving the lateral tubercle of the posterior talar process
- localized fluid and/or edema in the posterior joint recesses
MRI signal characteristics
- T1: low signal in areas of bone bruising
- T2/STIR: high signal posterior to ankle in areas of bone bruising
- PD/PD fat saturated: high signal posterior to the ankle
See also
Siehe auch:
- Os trigonum
- Processus Stieda
- Kager's triangle
- ventrales Impingementsyndrom am oberen Sprunggelenk
- Os trigonum Fraktur
- anteromediales Impingement am Sprunggelenk
und weiter:
Assoziationen und Differentialdiagnosen zu posteriores Impingement am Sprunggelenk:
ventrales
Impingementsyndrom am oberen Sprunggelenk