How to Diagnose Ankle Impingement Syndrome
Impingement lesions on the ankle are often caused by capsular or synovial irritation because of a sports-related injury. They also may result from infection, degenerative disease or congenital defects. Chronic ankle pain is experienced by up to 40 percent of patients after spraining an ankle. One-third of these may have ankle impingement syndrome.
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Instructions
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Gather the patient history. Inquire specifically about sports injuries, such as landing on an opponent's foot in basketball or stepping in a hole while running.
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Obtain the presenting symptoms of an ankle impingement. An anterolateral impingement usually causes a vague chronic pain while cutting or pivoting on that foot. A posterior impingement usually causes pain on the posterior or posterolateral ankle after an ankle sprain. A syndesmosis impingement constitutes 10 percent of ankle injuries, usually as the result of a high ankle sprain.
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3
Examine the affected ankle. Tenderness along the lateral gutter and anterior talofibular ligament indicates an anterolateral ankle impingement. Extreme tenderness along the interosseous membrane and syndesmosis suggests a syndesmosis impingement. A posterior impingement is more difficult to diagnose and often causes lingering pain that worsens upon plantar flexion.
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Take plain radiographs with the patient in a lunge position. This view may show a bone-on-bone impingement. A posterior impingement may show an enlarged posterior tubercle.
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Use a magnetic imaging resonance scan to see a meniscoid mass in the ankle's lateral gutter. This is visible in 30 percent of patients with an anterolateral ankle impingement.
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