Lateral Gutter Syndrome Ankle

Extreme tenderness along the syndesmosis and interosseous membrane is noted along with pain on bimalleolar compression of the syndesmosis and on passive external rotation stress of the ankle.

Lateral gutter syndrome ankle.

Historically it has been called athlete s ankle and footballer s ankle. Anterior ankle impingement typically occurs in athletes who have played years in sports that involve a kicking motion or repeated ankle extremes of motion. Anterolateral impingement syndrome of the ankle is caused by entrapment of the hypertrophic soft tissue in the lateral gutter. The impingement process begins when an inversion sprain tears the anterior talofibular and or the calcaneofibular ligament.

3 over time a meniscoid lesion is often the result of the lateral ankle injury. 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. The anterolateral ankle gutter is the most common site of ankle impingement.

The ankle impingement sign described by malloy uses thumb pressure over the lateral gutter while taking the ankle from a plantar flexed position to maximal dorsiflexion. The condition is common in athletes especially soccer players distance runners and ballet dancers. In this review the etiology pathoanatomy diagnostic workup and treatment options for both anterior and posterior ankle impingement syndromes are discussed. 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 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. While there is no posterolateral impingement syndrome there is a similar condition termed extra articular lateral hindfoot impingement syndrome elhis see also. Ankle impingement is a syndrome that encompasses a wide range of anterior and posterior joint pathology involving both osseous and soft tissue abnormalities. Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle.

Syndesmotic or a high ankle sprain occurs in up to 10 of all ankle injuries. The investigators noted that if hypertrophic synovitis is present this maneuver impinges the synovium between the neck of the talus and the distal tibia. The ligamentous injury is not severe enough to cause chronic instability. Noted in athletes whose sports necessitated sudden acceleration jumping and extremes of dorsiflexion or plantar flexion.

The key ankle impingement syndromes are. 3 during an inversion ankle injury the anterior talofibular ligament and calcaneofibular ligament are affected as is the distal syndesmosis. Medial and lateral gutter ankle impingement may result after total ankle replacement tar.