Lateral Gutter Syndrome

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.

Lateral gutter syndrome.

Lateral patellar plica the lateral patellar plica is the least common of the four knee plicae. Anterolateral impingement syndrome of the ankle is caused by entrapment of the hypertrophic soft tissue in the lateral gutter. Tenderness is noted along the lateral gutter and anterior talofibular ligament. 3 over time a meniscoid lesion is often the result of the lateral ankle injury.

1 30 lateral plicae originate from the lateral joint capsule coursing in the lateral gutter of the knee attaching to the infrapatellar fat pad. The anterolateral ankle gutter is the most common site of ankle impingement. The ligamentous injury is not severe enough to cause chronic instability. Ankle impingement syndromes may also be congenital in origin.

3 during an inversion ankle injury the anterior talofibular ligament and calcaneofibular ligament are affected as is the distal syndesmosis. The most common etiology is hypertrophy of the superior articular facets associated with lumbar instability and arthrosis of the posterior joint complex. Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle. The lateral recess syndrome lrs represents stenosis of the lateral subarticular gutter that will often lead to nerve root compression.

However inadequate immobilization and rehabilitation may lead to chronic inflammation in the ligament resulting in formation of scar tissue. Syndesmotic or a high ankle sprain occurs in up to 10 of all ankle injuries. 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. Patients will complain of pain around the anterolateral ankle gutter during weightbearing and may feel like the pain is deep in the joint.

Found an incidence of 20 7 on arthroscopy and 50 at cadaveric dissection. Most authors report a frequency of 1 3. The diagnosis may be. The leading causes of impingement lesions are posttraumatic injuries usually ankle sprains leading to chronic pain.