Ankle impingement is defined as pain in the ankle due to impingement in one of two areas.
Medial gutter of the ankle joint.
Through this sweeping examina tion a general assessment of the ankle joint is performed.
Indications for arthroscopic intervention of the medial or lateral gutter impingement include a minimum of 90 days preferably 6 months status post total ankle replacement pain localized to either or both malleolar regions with weight bearing isolated pain with palpation of the medial and or lateral gutters and radiographic evidence standing x ray or ct scan of.
Pain on the medial gutter of the ankle and a valgus and pronation deformity of the foot are hallmarks of the disorder.
The eight points are the deltoid ligament medial gutter medial talus central talus lateral talus talofibular articulation lateral gutter and anterior gutter.
It proved that the lateral.
From the tip the distal fibula and the shaft can be felt in its entirety by running the examiner s fingers proximally.
The examination of the osteology of the lateral ankle begins with the easily palpable tip of the fibula fig.
The deformity typically can be corrected by the activation of the posterior tibial muscle.
Further improvement of visualization of the posterior horn of the medial meniscus can sometimes be enhanced by gentle external rotation of the foot while the knee is flexed in the valgus position.
In contrast to stress radiographs arthroscopy is a helpful diagnostic tool in verifying medial instability.
Anterior anterolateral and anteromedial and posterior posteromedial 1 location of pain is referenced from the tibiotalar talocrural joint 2 anterior ankle impingement generally refers to entrapment of structures along the anterior margin of the tibiotalar joint in terminal dorsiflexion.
Typically the capsule and synovial lining of the ankle joint get inflamed and can develop scar tissue in either the anteromedial gutter or anterolateral gutter between the ankle bones.
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 1 4.
A stress fracture of the medial malleolus can occur but is very rare 2.
Synovitis synovitis is the inflammation of the synovial lining of a joint or tendon sheath.
The medial joint space typically opens up 3 5 to 4 mm to allow good visualization of the posterior horn of the medial meniscus.
The lateral gutter of the ankle joint can be found by running the thumb medially over the anterior and medial edge of the fibula.
Ankle impingement can occur after traumatic ankle sprains or even fractures.
