Location | Diagnosis | Notes |
---|---|---|
Lateral | Tenosynovitis, tendinosis and degenerative tears of peroneal tendons | Symptoms consist of pain and oedema laterally in the ankle along the peroneal tendons. There may sometimes be a history of ankle sprain associated with a tendon tear. The diagnosis can be made by MRI. Treatment is primarily conservative (such as reducing the strain, cold therapy and, for varus ankles, also insoles) but patients with difficult symptoms should be referred for assessment for operative treatment. |
Osteoarthritis of the subtalar joint | See here. | |
Stress fractures of the calcaneus | Pain, oedema and heat laterally in the heel. The diagnosis is evident even clinically due to the clear symptoms. The development of this condition requires a history of clear strain. | |
Coalition | Growth disturbances with an abnormal coalition developing between two bones. May cause restriction of movement or pain in the talocalcaneal joint. Coalition is most commonly situated between the calcaneus and the navicular bone, with symptoms typically occurring laterally in the area of the tarsal sinus. Treatment consists of surgical removal of the coalition. | |
Medial | Strain symptoms associated with flat foot, including tenosynovitis, tendinosis and tears of the posterior tibial tendon | See here. |
Medial instability of the ankle | A sequela of deltoid and/or spring ligament injury. Causes medial pain particularly when pushing off the foot. Clinically, the affected ankle can be found to give way' medially under strain more than the healthy ankle. Surgical treatment should be considered. | |
Tarsal tunnel syndrome, or syndroma canalis tarsi | Tibial nerve entrapment. Causes pain and numbness medially in the ankle and in the sole of the foot. There is tenderness along the course of the nerve, and Tinel's test may produce electric shock sensations. The entrapment is usually found by ENMG and treated surgically. See also Heel Pain. | |
Os tibiale externum | An accessory bone developing during growth at the attachment of the posterior tibial tendon at the medial aspect of the navicular bone. Very common and often asymptomatic. The symptoms, pain and friction symptoms, may start from trauma or without a cause in adulthood. Symptomatic bones can be removed surgically. | |
Posterior | Achilles tendon problems | See Achilles Tendinopathy and Tendon Rupture. |
Impingement or narrowness of the posterior ankle | Often posteromedial pain or snapping particularly when extending the ankle. Sometimes restricted range of movement of the big toe as the flexor hallucis longus tendon is entrapped at the back of the ankle. There may be an accessory bone called os trigonum. May cause symptoms without a reason (common in dancers) or as a result of trauma, particularly one involving overextension of the ankle. Can be treated surgically by arthroscopic debridement and excision of the accessory bone. | |
Anterior | Talocrural joint problems | Damaged cartilage OCD Osteoarthritis Anterior impingement after trauma, for example |
Osteoarthritis of the talonavicular joint | See here. | |
Tenosynovitis and tendinosis of the anterior tibial tendon | Fairly rare. Anteromedial pain and oedema extending to the distal tendon. Spontaneous total rupture is possible, the distal end of the tendon withdrawing to the level of the ankle joint and forming a resistance there. The ankle dorsiflexor loses strength, the foot starting to slap. Usually requires surgical correction. |