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J Foot Ankle Surg 2019 Mar 12. Epub 2019 Mar 12.

Professor, Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China. Electronic address:

Both osteoarthritis and impingement syndrome are the disorders commonly observed in sports medicine. However, failure in pain alleviation by surgical intervention introduces challenges in the diagnosis and decision-making for orthopedists. Hybrid single photon emission computed tomography/computed tomography (SPECT/CT) provides both functional and structural information of ankle pathology. Read More

Radiol Med 2019 Mar 14. Epub 2019 Mar 14.

Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.

Purpose: To retrospectively evaluate on magnetic resonance (MR) arthrography the relationship between joint capsule thickness and the stage of osteochondral lesions of the tibiotalar joint, as well as to evaluate the ankle joint capacity in patients with osteochondritis dissecans (OCD). Also, we demonstrate the unusual locations of osteochondral lesions of the ankle joint.

Methods: MR arthrography images were analyzed by two staff radiologists in consensus. Read More

J Am Acad Orthop Surg 2019 Feb 15. Epub 2019 Feb 15.

From the Department of Orthopaedic Surgery (Dr. Vosseller and Dr. Dennis), Columbia University Medical Center, and The ADAM Center (Dr. Bronner), The Alvin Ailey American Dance Theater, New York city, NY.

The term dance encompasses a broad range of different styles; much of the orthopaedic literature has focused on ballet dancers. Injury is common in dancers at all levels, and many serious dancers sustain multiple injuries as they progress through their career. Foot and ankle injuries are among the most common injuries experienced by dancers. Read More

J Can Chiropr Assoc 2018 Dec;62(3):202-210

Assistant Professor, Clinical Education, Canadian Memorial Chiropractic College.

Introduction: Os trigonum syndrome is a relatively uncommon condition, resulting from compression of a congenital bony anomaly (os trigonum) and adjacent soft tissues during repetitive hyper-plantarflexion. This condition is currently well-described in ballet, soccer, and running athletes, but few cases exist describing os trigonum syndrome in overhead athletes.

Case Presentation: A 22-year-old national level male javelin athlete presented with a recalcitrant history of posterior ankle pain following a hyper-plantarflexion mechanism. Read More

Kathmandu Univ Med J (KUMJ) 2018 Jan.-Mar;16(61):28-34

Department of Orthopedics, B and C Teaching Hospital, Birtamod, Jhapa.

Background Ankle and foot pain is a common clinical problem, that may be due to a variety of soft tissue and osseus abnormalities. Magnetic resonance imaging plays vital role for diagnosing internal derangement of the ankle joint, assessing soft tissue structures around the ankle such as tendons, ligaments, nerves and osseus structures. Method Retrospective magnetic resonance imaging evaluation of the ankle and foot was done in 100 patients using 0. Read More

J Foot Ankle Surg 2019 Mar 4;58(2):273-277. Epub 2019 Jan 4.

Assistant Professor, Department of Orthopaedics & Traumatology, Selçuk University School of Medicine, Konya, Turkey.

The prevalence of os trigonum and osteochondral lesions of talus (OCLT) have been presented in different prevalences among different groups in the literature for the patients with ankle impingement syndrome. Our main objective in the study was to determine the possible relationship between the impingement syndrome and the prevalence of os trigonum and OCLT in specific groups. The presence of anterior ankle impingement syndrome (AAIS), posterior ankle impingement syndrome (PAIS), os trigonum, OCLT, and the location of OCLT were evaluated in a blinded manner on magnetic resonance imaging from patients clinically considered to be diagnosed with ankle impingement syndrome from January 2014 to July 2017. Read More

Musculoskelet Sci Pract 2019 02 11;39:157-163. Epub 2018 Dec 11.

University of Brighton, Health Sciences, Robert Dodd Building, 49 Darley Road, Eastbourne, BN20 7UR, UK.

Musculoskeletal (MSK) conditions are very common and represent a major concern for the society and global health. The manual therapy technique Mulligan's Mobilisation with Movement (MWM) has shown promising results in treating a variety of MSK conditions. The aim of this review was to systematically review the literature to establish whether MWM treatment is effective for improving pain and function in patients with MSK conditions related to peripheral joints. Read More

Curr Rev Musculoskelet Med 2018 Dec;11(4):624-634

Department of Orthopedic Surgery, Stanford University, 450 Broadway St, Redwood City, CA, USA.

Purpose Of Review: This review evaluates current clinical literature on the use of platelet-rich plasma (PRP), including leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP), in order to develop evidence-based recommendations for various musculoskeletal indications.

Recent Findings: Abundant high-quality evidence supports the use of LR-PRP injection for lateral epicondylitis and LP-PRP for osteoarthritis of the knee. Moderate high-quality evidence supports the use of LR-PRP injection for patellar tendinopathy and of PRP injection for plantar fasciitis and donor site pain in patellar tendon graft BTB ACL reconstruction. Read More

Radiol Clin North Am 2018 Nov;56(6):893-916

Department of Radiology, MSK Division, University of Michigan Health System, 1500 Medical Center Drive-TC2910Q, Ann Arbor, MI 48109, USA.

Ankle impingement syndromes encompass various pathologic entities that contribute to ankle pain with limited range of motion. Although classically described in athletes, these changes can occur in individuals of all ages, often with a history of prior ankle trauma. Ankle impingement is broadly categorized as anterolateral, anterior, posterior, anteromedial, and posteromedial, depending on the area of the ankle affected. Read More

Knee Surg Sports Traumatol Arthrosc 2018 Oct 1. Epub 2018 Oct 1.

Aspetar Qatar Orthopaedic and Sports Medicine Hospital Doha, Near Khalifa Stadium, Doha, Qatar.

Purpose: The etiology and incidence of os trigonum syndrome in professional athletes is highly variable. There is a paucity of data to ascertain why some athletes evolve towards surgery whilst others remain asymptomatic. We hypothesized that a lateral ligament ankle injury would increase the likelihood for surgery in those athletes with os trigonum syndrome. Read More

Knee Surg Sports Traumatol Arthrosc 2018 Aug 29. Epub 2018 Aug 29.

Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain.

Purpose: The anterior tibiofibular ligament (ATiFL) and its distal fascicle have been the subject of numerous studies, mainly due to the involvement of this ligament in anterolateral soft-tissue impingement of the ankle. There is currently no firm evidence related to the incidence of the distal fascicle or the frequency with which it is in contact with the talus, or whether this is a constant anatomic finding. In addition, the terminology used to refer to this structure is not accurate and varies widely in previous studies. Read More

J Orthop Surg Res 2018 Jul 31;13(1):190. Epub 2018 Jul 31.

Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico, University of Rome, Via Alvaro del Portillo, 200, Rome, Italy.

Orthopedic sports medicine is a subspecialty of Orthopedics that focuses on managing pathological conditions of the musculoskeletal system arising from sports practice. When dealing with athletes, timing is the most difficult issue to face. Typically, athletes aim to return to play as soon as possible and at the pre-injury level. Read More

Rofo 2018 Apr 26;190(4):314-317. Epub 2018 Mar 26.

Radiologische Klinik, Universitätsklinikum Tübingen.

Clin J Sport Med 2018 Mar 23. Epub 2018 Mar 23.

Kramer Orthopedics, Newport Beach, CA.

Background: Literature regarding surfing injuries is scarce and most studies report a high number of minor injuries. Recent literature suggests that musculoskeletal injuries are more common than previously reported. In the mid 2000s, competitive surfing has seen an increase in aerial maneuvers, as they have become more highly rewarded by the judging panel, which may be contributing to a change in injury patterns. Read More

Arthrosc Tech 2018 Feb 1;7(2):e71-e76. Epub 2018 Jan 1.

Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China.

Identification of the correct source of symptoms is the key in formulating the correct treatment plan for heel pain after calcaneal malunion. Calcaneofibular and posterior ankle impingements can occur due to malunion of a joint depressed-type calcaneal fracture. The purpose of this Technical Note is to report the technical details of posterior and lateral decompression through the posteromedial and posterolateral portals using posterior ankle endoscopy. Read More

J Dance Med Sci 2018 Mar;22(1):19-32

Department of Orthopedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Dancing on pointe and relevé requires extreme plantar flexion of the talo-crural joint. Hence, these positions may lead to posterior ankle impingement syndrome (PAIS). PAIS often coincides with flexor hallucis longus tendinopathy (FHL tendinopathy, or "dancers' tendinitis"). Read More

J Dance Med Sci 2018 Mar;22(1):11-18

Medical Center for Dancers and Musician, The Hague Medical Center, The Netherlands.

Posterior ankle impingement syndrome (PAIS) is a painful, usually limited plantar flexion of the ankle joint due to soft tissue impingement or a bony impediment often coinciding with tendinopathy of the flexor hallucis longus (FHL) behind the medial malleolus. In persistent complaints, the bony impediment is removed, the tunnel of the FHL tendon is released, or a combination of both procedures has traditionally been performed by open surgery. In 2000, an endoscopic surgical technique for PAIS and FHL tendinopathy was introduced. Read More

J Dance Med Sci 2018 Mar;22(1):3-10

Medical Center for Dancer and Musician, The Hague Medical Center, The Netherlands.

Posterior ankle impingement syndrome (PAIS), the result of posterolateral soft tissue or bony impingement of the ankle, and tendinopathy of the flexor hallucis longus (FHL tendinopathy) in the ankle are common in dancers. If conservative treatment of these conditions fails to produce adequate results, surgical intervention might be necessary. However, outcomes of treatment by open surgery for these diagnoses have been described only in small series of dancers. Read More

J Foot Ankle Surg 2018 May - Jun;57(3):505-508. Epub 2018 Mar 1.

Department Manager, Sports Medicine (Orthopaedics), Fukui General Hospital, Fukui, Japan. Electronic address:

The purpose of the present study was to quantify the learning curve for arthroscopic os trigonum excision using the log-linear model. Twenty-three consecutive feet underwent arthroscopic os trigonum excision and release of the flexor hallucis longus. The required time from the beginning of shaving of the soft tissue until completion of os trigonum excision and release of the flexor hallucis longus (van Dijk time) was recorded. Read More

Arthrosc Tech 2017 Oct 9;6(5):e1829-e1835. Epub 2017 Oct 9.

Department of Orthopaedic and Sports Medicine, Graduate School of Medicine, Mie University, Tsu, Mie, Japan.

Longitudinal flexor hallucis longus (FHL) tendon tears are sometimes complicated by posterior ankle impingement syndrome (PAIS), especially in ballet dancers. In recent years, PAIS has been treated endoscopically, but it is difficult to suture FHL tendon tears endoscopically. In this report, we describe how to suture the FHL tendon endoscopically with the Meniscal Viper Repair system (Arthrex, Naples, FL). Read More

FP Essent 2018 Feb;465:24-29

University of Florida College of Medicine, PO Box 100237, Gainesville, FL 32610-0237.

Chronic ankle pain is relatively common in family medicine. Sequelae from lateral ankle sprains are the most common cause. Other etiologies include peroneal tendinopathy or subluxation, osteochondral injury, lateral ankle impingement, sinus tarsi syndrome, cuboid syndrome, bony stress injury, and other unusual factors. Read More

Physiother Theory Pract 2018 Jul 3;34(7):569-577. Epub 2018 Jan 3.

a Registered Physiotherapist , CBI Health Centre, Chilliwack , British Columbia , Canada.

This case report describes a 50-year-old male who presented with right anterolateral ankle pain managed unsuccessfully with rest, medications, bracing, injection, physical therapy, and massage therapy. Clinical diagnosis of anterolateral ankle impingement was based on concordant symptom reproduction with palpatory tenderness and a positive lateral synovial impingement test. This case report is a potential first time description of the successful management of anterolateral ankle impingement utilizing a novel Mulligan's mobilization with movement procedure (consisting of internal rotation of the distal tibia) and taping with immediate improvements noted in pain, range of motion, and function. Read More

Zhongguo Gu Shang 2016 Dec;29(12):1078-1083

Department of Joint Trauma, the Third Hospital Affiliated to Sun Yat-Sen university, Guangzhou 510000, Guangdong, China;

Objective: To analyze clinical efficiency and intraoperative considerations of ankle arthroscopy for ankle impingement syndrome through anterior and posterior passage.

Methods: From April 2011 to April 2015, the clinical data of 17 patients diagnosed as ankle impingement syndrome were performed arthroscopy, including 12 males and 5 females, with an average age of 32.4 years (ranging from 22 to 47). Read More

Clin Pediatr (Phila) 2018 Aug 28;57(9):1033-1040. Epub 2017 Nov 28.

4 Naval Hospital, Jacksonville, FL, USA.

The perception that children and adolescents have of injuries may be influenced by their depiction in sport-related films. The objective of this study was to determine the depiction of injuries in a select number of sport-related films. Forty-four films were analyzed. Read More

Foot Ankle Spec 2018 Feb 27;11(1):72-76. Epub 2017 Sep 27.

Department of Orthopedics (IT, FH, KS) and.

Ankle arthroscopy is an important diagnostic and therapeutic tool. Arthroscopic ankle surgery for anterior ankle impingement or osteochondral lesions (OCLs) is mostly performed with a 30° arthroscope; however, visualization of lesions is sometimes difficult. This study sought to compare ankle joint visualization between 70° and 30° arthroscopes and clarify the effectiveness of 70° arthroscopy. Read More

Orthop Traumatol Surg Res 2017 12 8;103(8S):S249-S252. Epub 2017 Sep 8.

CHU Ambroise-Paré, AP-HP, 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France. Electronic address:

Antero-lateral ankle impingement syndrome (ALAIS) is a well-established clinical entity that is a common consequence of ankle sprains. Injury to the anterior talo-fibular ligament plays a key role in the genesis of ALAIS. Arthroscopic antero-lateral synovectomy is the standard of care. Read More

Clin Radiol 2017 Dec 8;72(12):1014-1024. Epub 2017 Sep 8.

Department of Radiology, Universitair Ziekenhuis Brussel, Brussel, Belgium. Electronic address:

In this article we provide an overview of impingement syndromes of the lower limb. At the level of the hip, femoroacetabular and ischiofemoral impingement are recognised. At the level of the knee, we discuss Hoffa's fat pad impingement, suprapatellar fat pad impingement, pericruciate impingement, and iliotibial band syndrome. Read More

J Clin Orthop Trauma 2017 Aug 21;8(Suppl 1):S21-S25. Epub 2017 Jul 21.

Department of Rehabilitation, Indian Spinal Injuries Center, New Delhi, India.

Posterior ankle impingement syndrome (PAIS) is a clinical condition characterized by pain in the posterior aspect of ankle on performing activities requiring extreme plantar flexion. The impinging lesion could be bony and/or soft tissue. The operative treatment aims at removing the impinging lesion either by open or endoscopic surgery. Read More

Can Assoc Radiol J 2017 Nov 31;68(4):431-437. Epub 2017 Aug 31.

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Republic of Singapore. Electronic address:

Ankle impingement syndromes are a commonly encountered clinical entity seen in athletes, secondary to repetitive forceful microtrauma. Symptoms are related to impingement of osseous or soft tissue abnormalities in the ankle joint, in particular the tibiotalar joint, which may result in painful limitation of ankle movements. Imaging modalities, such as radiographs and magnetic resonance imaging, are very useful in diagnosing osseous and soft tissue abnormalities seen in different types of ankle impingement syndromes. Read More

Reumatol Clin 2018 Jul - Aug;14(4):244-245. Epub 2017 Aug 19.

Rheumatology Department, Hospital de São Teotónio, Viseu, Portugal.

Acta Ortop Mex 2017 Jan-Feb;31(1):24-29

División de Ortopedia, Hospital General «Dr. Manuel Gea González», Ciudad de México, México.

Background: Chronic pain on the posterior portion of the ankle is often due to posterior impingement between bony or soft tissue structures. The presence of an os trigonum or a prominent posterior apophysis of the talus can produce this impingement. The purpose of this study was to assess the outcome of hindfoot endoscopy in patients with a diagnosis of posterior ankle impingement. Read More

EFORT Open Rev 2017 May 11;2(5):230-240. Epub 2017 May 11.

Cerrahpasa Medical School, Departmant of Orthopaedics and Traumatology, University of Istanbul, Turkey.

The two-portal hindfoot arthroscopy is an effective procedure enabling direct visualisation of posterior ankle pathology with low invasiveness.An important stage of the hindfoot endoscopy is localisation of the flexor hallucis longus (FHL) tendon to protect the neurovascular bundle which is located just medial to it.Posterior ankle impingement syndrome and FHL tenosynovitis are common causes of posterior ankle pain and frequently occur together. Read More

Foot Ankle Spec 2018 Feb 15;11(1):61-66. Epub 2017 May 15.

Department of Radiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (LNN, NVG).

Background: Ankle impingement is a common cause of chronic ankle pain. We retrospectively studied the effectiveness of ultrasound-guided percutaneous needle fenestration of the pathological soft tissues combined with corticosteroid injection to treat this condition.

Methods: We administered a telephone survey to patients who underwent the procedure. Read More

Case Rep Orthop 2017 28;2017:2171627. Epub 2017 Mar 28.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Osteoid osteoma in periarticular lesions tends to have an unusual presentation that likely leads to a delayed or missed diagnosis compared with a typical osteoid osteoma in the metaphysis or diaphysis of the long bone. In cases that are unresponsive to conservative treatment, surgical interventions including en bloc resection, computed tomography-guided percutaneous treatment, and arthroscopic resection have been performed; however, these methods frequently result in inadequate tumor resection and recurrence. Here we present a case of a 16-year-old girl with osteoid osteoma in the talar neck presenting as anterior impingement syndrome due to marked synovitis in the ankle joint which was successfully treated without complications by arthroscopic synovectomy and tumor resection followed by intraoperative 3D C-arm-based imaging confirming complete tumor lesion removal. Read More

Orthop Nurs 2017 Mar/Apr;36(2):153-158

Erin Sullivan, CPNP, Department of Orthopaedic Surgery, Yawkey Center for Outpatient Care, Massachusetts General Hospital for Children, Boston. Jeremy Hudson, MSPT, Sollus Therapeutics LLC, 137 Newbury Street, Boston, MA.

The mind and the body are clearly intertwined in ways that are only now being discovered. In the orthopaedic world, injuries and diseases are often classified and described in a very organized, discrete fashion-The radius is fractured, the ACL or meniscus or rotator cuff is torn, the ankle is sprained, and/or the lumbar spine has a disc herniation. Although it is, in many ways, almost comforting to think about injuries or orthopaedic issues in this manner, what about the many patients who fail to fall into this classification? What about the thousands of patients with severe unexplained chronic pain or patients who just are not improving with the typical treatment algorithm. Read More

Radiologe 2017 Apr;57(4):309-326

Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Wien, Österreich.

Impingement syndrome of the ankle is a clinical diagnosis caused posttraumatically by overuse due to repetitive mechanical loading or the presence of predisposing anatomical variants. Ankle impingement syndrome is characterized by chronic pain and limited range of movement caused by mechanical compression of bony or soft tissues within the joint compartments. Ankle impingement syndrome is classified according to the various anatomical locations around the tibiotalar joint as anterior, anterolateral, anteromedial, posterior or posteromedial. Read More

J Foot Ankle Surg 2017 May - Jun;56(3):555-563. Epub 2017 Feb 28.

Research Assistant, St. John Hospital and Medical Center, Detroit, MI.

Haglund's syndrome is impingement of the retrocalcaneal bursa and Achilles tendon caused by a prominence of the posterosuperior calcaneus. Radiographic measurements are not sensitive or specific for diagnosing Haglund's deformity. Localization of a bone deformity and tendinopathy in the same sagittal section of a magnetic resonance imaging scan can assist with the diagnosis in equivocal cases. Read More

Foot Ankle Surg 2017 Mar 15;23(1):1-8. Epub 2016 Feb 15.

Hospital for Special Surgery, Department of Orthopaedic Surgery, 523 E 72nd Street, East River Professional Building, Ste 507, New York, NY 10021, United States. Electronic address:

Anterior ankle impingement is a common cause of chronic ankle pain, particularly in athletic populations. Morris and McMurray provided the earliest descriptions of anterior impingement, coining the condition as "athlete's ankle" or "footballer's ankle". The pathology has since been a topic of considerable investigation and has been re-termed "anterior ankle impingement syndrome". Read More

Am J Sports Med 2017 May 23;45(6):1388-1394. Epub 2017 Jan 23.

424 Military General Hospital, Thessaloniki, Hellas.

Background: Open surgical excision of the os trigonum has been the traditional treatment for posterior ankle impingement syndrome (PAIS). However, the endoscopic excision has recently become quite popular. Purpose/Hypothesis: The purpose of our study was to compare the results of endoscopic versus open excision of a symptomatic os trigonum for the treatment of PAIS in an athletic population. Read More

J Orthop Sci 2017 May 10;22(3):463-467. Epub 2017 Jan 10.

Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi, Tokyo, 173-8605, Japan.

Background: It is unclear whether simultaneous surgery for posterior ankle impingement syndrome (PAIS) and concomitant ankle disorders, such as anterior ankle impingement syndrome (AAIS), lateral ankle instability (LAI), and osteochondral lesion of the talus (OLT), allows for early return to athletic activity.

Methods: Ninety-seven patients who engaged in athletic activity (mean age 27 [range 18-43] years) and were treated by a hindfoot endoscopic approach for PAIS alone or simultaneously for PAIS and concomitant ankle disorders were included in this study. The patients were divided into four groups: PAIS alone (group A, n = 61), PAIS with AAIS (group B, n = 8), PAIS with LAI with or without AAIS (group C, n = 20), and PAIS with OLT with or without AAIS/LAI (group D, n = 8). Read More

Acta Chir Orthop Traumatol Cech 2016 ;83(6):399-404

Oddělení úrazové chirurgie, nemocnice České Budějovice, a.s.

PURPOSE OF THE STUDY Peripheral fractures of the talus (lateral talar process and posterior talar process) are rare injuries, easy to miss on examination due to their location and clinical manifestation. They account for 0.3% to 1. Read More

J Foot Ankle Surg 2017 Jan - Feb;56(1):22-25

Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.

The present study reports the clinical results of excision of a symptomatic os trigonum using an endoscopic procedure in professional ballet dancers. The hypothesis was that posterior endoscopic excision of the os trigonum would be safe and effective in treating posterior ankle impingement syndrome related to the os trigonum. Twelve professional dancers underwent excision of a symptomatic os trigonum for PAIS using a posterior endoscopic technique after failure of conservative treatment. Read More

Rev Esp Cir Ortop Traumatol 2017 Mar - Apr;61(2):104-110. Epub 2016 Dec 9.

Unidad de Artroscopia, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario 12 de Octubre, Madrid, España; Departamento de Cirugía, Universidad Complutense de Madrid, Madrid, España.

Introduction: Ankle sprains are one of the most common injuries. Despite appropriate conservative treatment, approximately 20-40% of patients continue to have chronic ankle instability and pain. In 75-80% of cases there is an isolated rupture of the anterior talofibular ligament. Read More

Acta Orthop Traumatol Turc 2016 Dec 3;50(6):649-654. Epub 2016 Dec 3.

Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.

Objective: To describe a clinical treatment algorithm for posterior ankle impingement (PAI) syndrome in professional football players.

Material And Methods: A case series of 26 elite professional football players diagnosed and treated for posterior ankle impingement syndrome were included for the study. All of the athletes received conservative treatment with physical therapy modalities initially. Read More

Magn Reson Imaging Clin N Am 2017 Feb 20;25(1):63-77. Epub 2016 Oct 20.

Department of Radiology, University of Missouri, 3801 Kinsey Court, Columbia, MO 65203, USA. Electronic address:

Abnormalities of the medial ligaments and posterior tibial tendon can occur because of acute injury or chronic instability or malalignment. Medial ankle injuries may occur because of pronation or supination-external rotation injuries. Deltoid ligament injuries have a significant impact on lateral ankle instability but can be overlooked in patients with lateral ligament injuries. Read More

Magn Reson Imaging Clin N Am 2017 Feb;25(1):145-158

Musculoskeletal Centre X-Ray Department, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK. Electronic address:

Impingement is a clinical syndrome of chronic pain and restricted range of movement caused by compression of abnormal bone or soft tissue within the ankle joint. It usually occurs following a sprain injury or repetitive microtrauma causing haemorrhage, synovial hyperplasia, and abnormal soft tissue interposition within the joint. MR imaging is particularly valuable in being able to detect not only the soft tissue and osseous abnormalities involved in these syndromes, but also a wide variety of other potential causes of ankle pain and instability that also may need to be addressed clinically. Read More

Magn Reson Imaging Clin N Am 2017 Feb;25(1):11-26

Department of Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. Electronic address:

Accessory muscles around the ankle are commonly encountered as incidental findings on cross-sectional imaging. Mostly asymptomatic, accessory muscles sometimes mimic mass lesions. They have been implicated as the cause of tarsal tunnel syndrome, impingement of surrounding structures, and chronic pain. Read More

Br J Radiol 2017 Feb 25;90(1070):20160735. Epub 2016 Nov 25.

1 Department of Radiology, University of California, San Diego, CA, USA.

Ankle impingement syndromes encompass a broad spectrum of post-traumatic and chronic degenerative changes that present with pain on specific movements about the ankle joint. Both amateur and professional athletes are disproportionately affected by these conditions, and while conservative measures can potentially treat an impingement syndrome, definitive therapy is often alleviated surgically. Imaging (including conventional radiography, ultrasound, CT and MRI) plays an invaluable role in the diagnosis and pre-surgical work-up. Read More

Eur J Radiol 2016 Dec 17;85(12):2238-2256. Epub 2016 Oct 17.

Department of Radiology, Changi General Hospital, 2 Simei Street 3, 529889, Singapore. Electronic address:

Posterior ankle pain is a cause of chronic pain and disability, afflicting a wide range of individuals. While proper identification of the cause is essential for timely and adequate treatment, identifying the cause and excluding mimickers is often challenging for the physician due to the complex nature of the joint. In addition, pathology that can cause posterior ankle pain may occur on their own or in co-existence. Read More

World J Orthop 2016 Oct 18;7(10):657-663. Epub 2016 Oct 18.

Youichi Yasui, Department of Orthopaedic Surgery, 2 Teikyo University School of Medicine, Tokyo 173-8606, Japan.

Posterior ankle impingement syndrome (PAIS) is a common injury in athletes engaging in repetitive plantarflexion, particularly ballet dancers and soccer players. Despite the increase in popularity of the posterior two-portal hindfoot approach, concerns with the technique remain, including; the technical difficulty, relatively steep learning curve, and difficulty performing simultaneous anterior ankle arthroscopy. The purpose of the current literature review is to provide comprehensive knowledge about PAIS, and to describe a systematic four-stage approach of the posterior two-portal arthroscopy. Read More