Anterolateral impingement syndrome of the ankle is caused by entrapment of the hypertrophic soft tissue in the lateral gutter.
Anterolateral gutter ankle.
9 pain can be elicited with passive dorsiflexion and eversion.
The ligamentous injury is not severe enough to cause chronic instability.
The anterolateral ankle gutter is the most common site of ankle impingement.
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.
It is an uncommon cause of chronic lateral ankle pain 6 typically seen in athletes 3 5.
Paterson r brown j roberts s.
This irritation and hypertrophy of the tissue can cause pain with ankle dorsiflexion and subsequently symptoms with athletic activities.
These likely present sources of anterolateral gutter impingement.
An audible click may also be heard during ankle range of motion.
3 during an inversion ankle injury the anterior talofibular ligament and calcaneofibular ligament are affected as is the distal syndesmosis.
The impingement process begins when an inversion sprain tears the anterior talofibular and or the calcaneofibular ligament.
Conventional mr imaging of the ankle is insensitive for anterolateral impingement.
Read ankle impingement syndomes article.
Anterior talofibular ligament is weakest of lateral ligaments.
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.
Axial t2 weighted image shows nodular soft tissue occupying anterolateral gutter arrow.
Ankle impingement can occur after traumatic ankle sprains or even fractures.
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.
Anterolateral ankle impingement has been known under the term anterolateral meniscoid lesion which is the result of synovitis in the anterolateral gutter.
3 over time a meniscoid lesion is often the result of the lateral ankle injury.
Soft tissue swelling is present in the anterolateral shoulder of the ankle joint and palpable masses are occasionally noted within the lateral gutter.
Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle.
Medial and lateral gutter ankle impingement may result after total ankle replacement tar.
Torn anterior talofibular ligament seen in more distal.
It extends from anterolateral malleolar tip to talar neck stabilizing talus.
However inadequate immobilization and rehabilitation may lead to chronic inflammation in the ligament resulting in formation of scar tissue.
Patients will complain of pain around the anterolateral ankle gutter during weightbearing and may feel like the pain is deep in the joint.
19 year old woman with continued ankle pain after sprain.
