These likely present sources of anterolateral gutter impingement.
Anterolateral gutter ankle.
Paterson r brown j roberts s.
It is an uncommon cause of chronic lateral ankle pain 6 typically seen in athletes 3 5.
Conventional mr imaging of the ankle is insensitive for anterolateral impingement.
Anterior talofibular ligament is weakest of lateral ligaments.
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.
It extends from anterolateral malleolar tip to talar neck stabilizing talus.
3 during an inversion ankle injury the anterior talofibular ligament and calcaneofibular ligament are affected as is the distal syndesmosis.
3 over time a meniscoid lesion is often the result of the lateral ankle injury.
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.
The anterolateral ankle gutter is the most common site of ankle impingement.
19 year old woman with continued ankle pain after sprain.
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.
Read ankle impingement syndomes article.
The impingement process begins when an inversion sprain tears the anterior talofibular and or the calcaneofibular ligament.
An audible click may also be heard during ankle range of motion.
The ligamentous injury is not severe enough to cause chronic instability.
Anterolateral impingement syndrome of the ankle is caused by entrapment of the hypertrophic soft tissue in the lateral gutter.
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.
Torn anterior talofibular ligament seen in more distal.
9 pain can be elicited with passive dorsiflexion and eversion.
Soft tissue swelling is present in the anterolateral shoulder of the ankle joint and palpable masses are occasionally noted within the lateral gutter.
This click has been attributed to aitfl impingement.
Anterolateral ankle impingement has been known under the term anterolateral meniscoid lesion which is the result of synovitis in the anterolateral gutter.
Axial t2 weighted image shows nodular soft tissue occupying anterolateral gutter arrow.
Medial and lateral gutter ankle impingement may result after total ankle replacement tar.
Ankle impingement can occur after traumatic ankle sprains or even fractures.
Patients will complain of pain around the anterolateral ankle gutter during weightbearing and may feel like the pain is deep in the joint.
However inadequate immobilization and rehabilitation may lead to chronic inflammation in the ligament resulting in formation of scar tissue.
