Medial Gutter Of The Ankle Joint

Ankle impingement is defined as pain in the ankle due to impingement in one of two areas.

Medial gutter of the ankle joint.

The eight points are the deltoid ligament medial gutter medial talus central talus lateral talus talofibular articulation lateral gutter and anterior gutter. The examination of the osteology of the lateral ankle begins with the easily palpable tip of the fibula fig. The medial malleolus is the bony bit on the inside of the ankle. 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.

From the tip the distal fibula and the shaft can be felt in its entirety by running the examiner s fingers proximally. It causes pain on the inside of the ankle which is exacerbated by activity especially running and jumping activities. The deformity typically can be corrected by the activation of the posterior tibial muscle. Anterior anterolateral and anteromedial and posterior posteromedial 1 location of pain is referenced from the tibiotalar talocrural joint 2 anterior ankle impingement generally refers to entrapment of structures along the anterior margin of the tibiotalar joint in terminal dorsiflexion.

In contrast to stress radiographs arthroscopy is a helpful diagnostic tool in verifying medial instability. The lateral gutter of the ankle joint can be found by running the thumb medially over the anterior and medial edge of the fibula. It proved that the lateral. Anteromedial ankle impingement can occur as a consequence of anterior tibiotalar ligament injury with subsequent synovitis osteophyte formation from repetitive microtrauma fractures and or chronic ankle instability causing mechanical entrapment of the anteromedial part of the tibiotalar joint capsule 1 4.

Further improvement of visualization of the posterior horn of the medial meniscus can sometimes be enhanced by gentle external rotation of the foot while the knee is flexed in the valgus position. You will have specific point tenderness over the medial malleolus where the fracture is. Indications for arthroscopic intervention of the medial or lateral gutter impingement include a minimum of 90 days preferably 6 months status post total ankle replacement pain localized to either or both malleolar regions with weight bearing isolated pain with palpation of the medial and or lateral gutters and radiographic evidence standing x ray or ct scan of. A stress fracture of the medial malleolus can occur but is very rare 2.

Pain on the medial gutter of the ankle and a valgus and pronation deformity of the foot are hallmarks of the disorder. The medial joint space typically opens up 3 5 to 4 mm to allow good visualization of the posterior horn of the medial meniscus.