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