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