Is anterior and posterior ankle impingement under-diagnosed? A review

Abstract

The impingement of the ankle is diagnosed based on history, clinical signs, physical examination, and conventional radiographic observations and is often a diagnosis of exclusion. Normal X-rays may display spurs, but are mainly useful in the evaluation of other osseous and articular diseases, which may masquerade impingement symptoms. Orthopedic literature seems to embrace the idea that magnetic resonance imaging (MRI) plays a significant role in pre-operative imaging of impingement lesions and MRI is a highly useful method for evaluating acute and chronic foot and ankle disorders. Arthroscopy of the ankle is an important minimally invasive procedure for the treatment of this disease. The majority of patients who have refractory symptoms are treated for ankle impingement using debridement through arthroscopy or an open procedure. According to recent reports, arthroscopic patients for osseous impingement had done better than soft-tissue impingement arthroscopic patients. Ankle arthroscopy has outstanding functional outcomes with few complications and reproducible results. Diagnosis and treatment should be initiated immediately in sportsmen so that the competing athlete can return to sport in an expedient way. The surgeon’s increased suspicion of this disorder is necessary to avoid substantial loss of time and early management. This review highlights the author’s arthroscopic method of impingement resection and discusses the latest available literature on etiopathogenesis, diagnosis, and management of both anterior and posterior ankle impingement. A greater understanding of this disorder can assist the clinician in the early diagnosis and intervention of impingement in sportsmen and dancers. Early diagnosis and intervention are the foundation for successful return to the profession and daily activities.