It is an uncommon cause of chronic lateral ankle pain 6 typically seen in athletes 3 5.
Anterolateral gutter ankle.
3 over time a meniscoid lesion is often the result of the lateral ankle injury.
Anterolateral impingement of the ankle is a relatively uncommon cause of chronic lateral ankle pain produced by entrapment of abnormal soft tissue in the anterolateral gutter of the ankle 2 4.
It extends from anterolateral malleolar tip to talar neck stabilizing talus.
Anterolateral ankle impingement has been known under the term anterolateral meniscoid lesion which is the result of synovitis in the anterolateral gutter.
The impingement process begins when an inversion sprain tears the anterior talofibular and or the calcaneofibular ligament.
An audible click may also be heard during ankle range of motion.
This irritation and hypertrophy of the tissue can cause pain with ankle dorsiflexion and subsequently symptoms with athletic activities.
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.
19 year old woman with continued ankle pain after sprain.
However inadequate immobilization and rehabilitation may lead to chronic inflammation in the ligament resulting in formation of scar tissue.
Impingement after tar can be a source of pain and decreased patient satisfaction which in turn results in poor outcomes 1impingement is of an unknown complex etiology and is likely multifactorial.
Conventional mr imaging of the ankle is insensitive for anterolateral impingement.
3 during an inversion ankle injury the anterior talofibular ligament and calcaneofibular ligament are affected as is the distal syndesmosis.
Paterson r brown j roberts s.
Anterior talofibular ligament is weakest of lateral ligaments.
Anterior talofibular ligament thickening and soft tissue fullness in the lateral gutter may be suggestive of the diagnosis but the reliability of the latter finding is questionable.
Torn anterior talofibular ligament seen in more distal.
Ankle impingement can occur after traumatic ankle sprains or even fractures.
Axial t2 weighted image shows nodular soft tissue occupying anterolateral gutter arrow.
Medial and lateral gutter ankle impingement may result after total ankle replacement tar.
The ligamentous injury is not severe enough to cause chronic instability.
Read ankle impingement syndomes article.
9 pain can be elicited with passive dorsiflexion and eversion.
Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle.
Anterolateral impingement syndrome of the ankle is caused by entrapment of the hypertrophic soft tissue in the lateral gutter.
The anterolateral ankle gutter is the most common site of ankle impingement.
These likely present sources of anterolateral gutter impingement.
The osteochondral loose body likely originates from a full thickness sharply marginated chondral loss along the anterior aspects of the tibial plafond measuring 6 x 8 mm in dimension.
