Causes chronic ankle pain
Anterior tibiotalar spurs (osteophytes) in typical positions on anterior tibia and talus within joint capsule
Due to supination or forced dorsiflexion injuries
Common in ballet and football
About 50% of anterior tibiotalar spurs are symptomatic for anterior impingement
Clinical features:
Pain on dorsiflexion
Restricted and painful dorsiflexion
Occasionally palpable soft-tissue swelling
Radiographs:
Only imaging needed in most
Tibiotalar spurs in typical positions, talar spurs on medial aspect and tibial spurs on lateral aspect
MR:
Tibiotalar spurs within capsular margin
Marrow edema uncommon
Synovial thickening (low on T1 and low-to-int on T2 with irregular contour or stranding)
Management:
Physiotherapy
Arthroscopic resection of osseous spurs and soft-tissue abnormality with washout of the joint
References:
Robinson P et al. Soft-Tissue and Osseous Impingement Syndromes of the Ankle: Role of Imaging in Diagnosis and Management. Radiographics. 2002;22:1457-1469
