3 during an inversion ankle injury the anterior talofibular ligament and calcaneofibular ligament are affected as is the distal syndesmosis.
Anterolateral gutter ankle.
Ankle impingement syndromes may also be congenital in origin.
The anterolateral ankle gutter is the most common site of ankle impingement.
Anterolateral ankle impingement has been known under the term anterolateral meniscoid lesion which is the result of synovitis in the anterolateral gutter.
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 fig.
3 over time a meniscoid lesion is often the result of the lateral ankle injury.
Significant scarring and irregularity of the anterior talofibular ligament with chronic appearing periosteal stripping occurring at the fibular origin.
Abrasion of the anterolateral talar dome ar ticular surface and secondary chondral inju ry may develop 15.
The leading causes of impingement lesions are posttraumatic injuries usually ankle sprains leading to chronic pain.
Anterolateral impingement syndrome of the ankle is caused by entrapment of the hypertrophic soft tissue in the lateral gutter.
Patients experience anterolateral ankle pain that is intensified with supination or pronation of the foot anterolateral point tenderness pain with a single leg squat and swelling.
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.
Patients may have a history of ankles sprains or chronic ankle instability and now present with constant lateral ankle pain upon ambulation.
These likely present sources of anterolateral gutter impingement.
There is scar tissue and synovitis within the anterolateral gutter as well as a 5 mm osteochondral loose body.
Soft tissue swelling is present in the anterolateral shoulder of the ankle joint and palpable masses are occasionally noted within the lateral gutter.
An audible click may also be heard during ankle range of motion.
Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle.
The impingement process begins when an inversion sprain tears the anterior talofibular and or the calcaneofibular ligament.
Patients with anterolateral impingement present with chronic ankle pain swelling along the anterolateral aspect of the ankle and limited dorsiflexion.
9 pain can be elicited with passive dorsiflexion and eversion.
