Ankle Lateral Gutter

Anterolateral ankle impingement 4.

Ankle lateral gutter.

The lateral gutter of the ankle joint can be found by running the thumb medially over the anterior and medial edge of the fibula. The impingement process begins when an inversion sprain tears the anterior talofibular and or the calcaneofibular ligament. Ankle impingement is defined as pain in the ankle due to impingement in one of two areas. It is an uncommon cause of chronic lateral ankle pain 6 typically seen in athletes 3 5.

The ligamentous injury is not severe enough to c. Repetitive synovial inflammation secondary to chronic lateral ankle instability produces a soft tissue mass consisting of hypertrophic synovial tissue and fibrosis within the lateral gutter. Often nonoperative management is not successful in the setting of impingement after tar. The examination of the osteology of the lateral ankle begins with the easily palpable tip of the fibula fig.

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 anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle. Fractures of the medial or lateral malleoli can lead to ankle joint instability and loss of normal ankle joint alignment. Medial and lateral gutter ankle impingement may result after total ankle replacement tar. The anterolateral ankle gutter is the most common site of ankle impingement.

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. 3 during an inversion ankle injury the anterior talofibular ligament and calcaneofibular ligament are affected as is the distal syndesmosis. Impingement after tar can be a source of pain and decreased patient satisfaction which in turn results in poor outcomes 1 impingement is of an unknown complex etiology and is likely multifactorial. The posterior edge of the distal tibia is sometimes referred to as the.

Patients will complain of pain around the. Anterolateral ankle impingement has been known under the term anterolateral meniscoid lesion which is the result of synovitis in the anterolateral gutter. From the tip the distal fibula and the shaft can be felt in its entirety by running the examiner s fingers proximally. The joint extends into the lateral gutter 1 and the medial gutter 2 the joint is evenly spaced throughout.

Ankle anatomy normal lateral. Anterior anterolateral and anteromedial and posterior posteromedial 1 location of pain is referenced from the tibiotalar talocrural joint 2 anterior ankle impingement generally refers to entrapment of structures along the anterior margin of the tibiotalar joint in terminal dorsiflexion.