Fact-sheet: Anterolateral soft-tissue impingement of the ankle
Updated on 02/01/2024 at 6:46 PM
View all RADEOS cases associated with this fact-sheet
Definition
Chronic anterolateral pre-malleolar ankle pain related to interposition of non-osseous soft tissue in the anterolateral gutter of post-traumatic origin
Clinical features
History of ankle ligamentous injury in the preceding weeks or months, most often during an inversion injury resulting in a lesion of the lateral ligament complex
Mechanical pain located over the anterolateral gutter, triggered by dorsiflexion or eversion of the ankle
Worsening of pain with prolonged standing, walking, or climbing stairs
+/- sensation of instability
Radiography
Useful to look for associated lesions and for differential diagnosis, searching for tibial or talar bone spurs (bony impingement), osteochondral lesion of the talar dome, or intra-articular foreign body
MRI
- Filling of the anterolateral gutter by a fibrous tissue mass distinct from the ATFL, displacing the adjacent fatty tissue
- Post-traumatic synovitis that organizes as a fibrous band and then as a low-signal meniscoid lesion
- Subacute tear with incomplete healing of the ATFL
- Rule out other causes of chronic post-traumatic ankle pain
Differential diagnosis
- Osteochondral lesion
- Fracture
- Osteoarthritis
- Osteophytosis and bony impingement
- Intra-articular foreign body
- Tendinopathy
- Fibular tendon injury
- Sinus tarsi syndrome
