Ankle impingement can occur after traumatic ankle sprains or even fractures. 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. This irritation and hypertrophy of the tissue can cause pain with ankle dorsiflexion and subsequently symptoms with athletic activities.

Location of medial ankle impingement
Ankle impingement can hurt along the medial gutter as well (white circle).

A sports medicine physician can try to make this diagnosis by physical examination, recreating the patient’s symptoms by palpation of the area of inflammation and impingement. X-rays are often unremarkable, but an MRI or MR arthrogram may demonstrate the impingement. Treatment often involves arthroscopically debriding the area of impingement. Return to sports is usually successful in athletes with this problem.

Location of lateral ankle impingement pain
Ankle impingement can cause pain along the lateral ankle gutter (white circle).

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