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Diagnostic imaging of ankle impingement syndromes in athletes

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Abstract

The chronic ankle pain is a very frequent clinical problem, which is often characterized by a painful mechanical limitation of full-range ankle movement. A large amount of causes are involved in its pathogenesis, but the most common forms are secondary to an osseous or soft tissue abnormality. Especially for professional athletes, impingement lesions are the most important causes of chronic pain; however, this symptomatology can also affect ordinary people, mostly in those who work in environments that cause severe mechanical stress on the joints. This group of pathologies is characterized by a joint conflict secondary to an abnormal contact among bone surfaces or between bones and soft tissues. Diagnosis is mainly clinic and secondly supported by imaging in order to localize the critical area of impingement and determine the organic cause responsible for the joint conflict. Treatments for different forms of impingement are similar. Usually, the first step is a conservative approach (rest, physiotherapy, ankle bracing, shoe modification and local injection of corticosteroids), and only in case of unsuccessful response, the second step is the operative treatment with open and arthroscopic techniques. The aim of the study is to describe different MR imaging patterns, comparing our data with those reported in the literature, in order to identify the best accurate diagnostic protocol.

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References

  1. Bureau NJ, Cardinal E, Hobden R, Aubin B (2000) Posterior ankle impingement syndrome: MR imaging findings in seven patients. Radiology 215(2):497–503

    PubMed  CAS  Google Scholar 

  2. Cerezal L, Abascal F, Canga A, Pereda T, García-Valtuille R, Pérez-Carro L, Cruz A (2003) MR imaging of ankle impingement syndromes. AJR Am J Roentgenol 181(2):551–559

    Article  PubMed  Google Scholar 

  3. Choo HJ, Suh JS, Kim SJ, Huh YM, Kim MI, Lee JW (2008) Ankle MRI for anterolateral soft tissue impingement: increased accuracy with the use of contrast-enhanced fat-suppressed 3D-FSPGR MRI. Korean J Radiol 9(5):409–415. doi:10.3348/kjr.2008.9.5.409

    Article  PubMed  Google Scholar 

  4. Cochet H, Pelé E, Amoretti N, Brunot S, Lafenêtre O, Hauger O (2010) Anterolateral ankle impingement: diagnostic performance of MDCT arthrography and sonography. AJR Am J Roentgenol 194(6):1575–1580. doi:10.2214/AJR.09.3650

    Article  PubMed  Google Scholar 

  5. Colao A, Marzullo P, Vallone G, Giaccio A, Ferone D, Rossi E, Scarpa R, Smaltino F, Lombardi G (1999) Ultrasonographic evidence of joint thickening reversibility in acromegalic patients treated with lanreotide for 12 months. Clin Endocrinol (Oxf) 51(5):611–618

    Article  CAS  Google Scholar 

  6. Colao A, Cannavò S, Marzullo P, Pivonello R, Squadrito S, Vallone G, Almoto B, Bichisao E, Trimarchi F, Lombardi G (2003) Twelve months of treatment with octreotide-LAR reduces joint thickness in acromegaly. Eur J Endocrinol 148(1):31–38

    Article  PubMed  CAS  Google Scholar 

  7. Colao A, Pivonello R, Scarpa R, Vallone G, Ruosi C, Lombardi G (2005) The acromegalic arthropathy. J Endocrinol Invest 28(8 Suppl):24–31

    PubMed  CAS  Google Scholar 

  8. Datir A, Connell D (2010) Imaging of impingement lesions in the ankle. Top Magn Reson Imaging 21(1):15–23. doi:10.1097/RMR.0b013e31820ef46b

    Article  PubMed  Google Scholar 

  9. de Oliveira Lima CMA, Ribeiro EB, Coutinho EPD, Vianna EM, Domingues RC, Coutinho Júnior AC (2010) Magnetic resonance imaging of ankle impingement syndrome: iconographic essay. Radiologia Brasileira 43(1):53–57

    Article  Google Scholar 

  10. Ferkel RD, Tyorkin M, Applegate GR, Heinen GT (2010) MRI evaluation of anterolateral soft tissue impingement of the ankle. Foot Ankle Int 31(8):655–661. doi:10.3113/FAI.2010.0655

    Article  PubMed  Google Scholar 

  11. Genovese E, Angeretti MG, Ronga M, Leonardi A, Novario R, Callegari L, Fugazzola C (2007) Follow-up of collagen meniscus implants by MRI. Radiol Med 112(7):1036–1048

    Article  PubMed  CAS  Google Scholar 

  12. Gerstner Garces JB (2012) Chronic ankle instability. Foot Ankle Clin 17(3):389–398. doi:10.1016/j.fcl.2012.06.001

    Article  PubMed  Google Scholar 

  13. Macarini L, Murrone M, Marini S, Mocci A, Ettorre GC (2004) MRI in ACL reconstructive surgery with PDLLA bioabsorbable interference screws: evaluation of degradation and osteointegration processes of bioabsorbable screws. Radiol Med 107(1–2):47–57

    PubMed  Google Scholar 

  14. Macarini L, Muscarella S, Lelario M, Stoppino L, Scalzo G, Scelzi A, Armillotta M, Sforza N, Vinci R (2011) Rotator cable at MR imaging: considerations on morphological aspects and biomechanical role. Radiol Med 116(1):102–113

    Article  PubMed  CAS  Google Scholar 

  15. Maquirriain J (2005) Posterior ankle impingement. J Am Acad Orthop Surg 13:365–371

    PubMed  Google Scholar 

  16. Messiou C, Robinson P, O’Connor PJ et al (2006) Subacute posteromedial impingement of the ankle in athletes: MR imaging evaluation and ultrasound guided therapy. Skeletal Radiol 35:88–94

    Article  PubMed  Google Scholar 

  17. Paterson RS, Brown JN, Roberts SNJ (2001) The posteromedial impingement lesion of the ankle: a series of six cases. Am J Sports Med 29:550–557

    PubMed  CAS  Google Scholar 

  18. Peace KAL, Hillier JC, Hulme A et al (2004) MRI features of posterior ankle impingement syndrome in ballet cancers: a review of 25 cases. Clin Radiol 59:1025–1033

    Article  PubMed  CAS  Google Scholar 

  19. Robinson P (2007) Impingement syndromes of the ankle. Eur Radiol. 17(12):3056–65. [Epub 2007 May 15. Review]

    Google Scholar 

  20. Robinson P (2008) Impingement and entrapment syndromes. Semin Musculoskelet Radiol 12(2):105. doi:10.1055/s-2008-1078698

    Article  PubMed  Google Scholar 

  21. Robinson P, White LM (2002) Soft-tissue and osseous impingement syndromes of the ankle: role of imaging in diagnosis and management. Radiographics. 22(6):1457–69, discussion 1470–1

    Google Scholar 

  22. Robinson P, White LM, Salonen DC, Daniels TR, Ogilvie-Harris D (2001) Anterolateral ankle impingement: MR arthrographic assessment of the anterolateral recess. Radiology 221(1):186–190

    Article  PubMed  CAS  Google Scholar 

  23. Robinson P, White LM, Salonen D, Ogilvie-Harris D (2002) Anteromedial impingement of the ankle: using MR arthrography to assess the anteromedial recess. AJR Am J Roentgenol 178(3):601–604

    Article  PubMed  CAS  Google Scholar 

  24. Ronga M, Grassi FA, Montoli C, Bulgheroni P, Genovese E, Cherubino P (2005) Treatment of deep cartilage defects of the ankle with matrix-induced autologous chondrocyte implantation (MACI). Foot Ankle surg 11:29–33

    Article  Google Scholar 

  25. Rosenberg ZS, Beltran J, Bencardino JT (2000) From the RSNA refresher courses. Radiological Society of North America. MR imaging of the ankle and foot. Radiographics 20:S153–S179

    PubMed  Google Scholar 

  26. Sanders TG, Rathur SK (2008) Impingement syndromes of the ankle. Magn Reson Imaging Clin N Am 16(1):29–38. doi:10.1016/j.mric.2008.02.005

    Article  PubMed  Google Scholar 

  27. Sofka CM (2013) Postoperative magnetic resonance imaging of the foot and ankle. J Magn Reson Imaging 37(3):556–565. doi:10.1002/jmri.23792

    Article  PubMed  Google Scholar 

  28. Sofka CM, Adler RS, Saboeiro GR, Pavlov H (2010) Sonographic evaluation and sonographic-guided therapeutic options of lateral ankle pain: peroneal tendon pathology associated with the presence of an os peroneum. HSS J 6(2):177–181. doi:10.1007/s11420-010-9154-3

    Article  PubMed  Google Scholar 

  29. Umans H (2002) Ankle impingement syndromes. Semin Musculoskelet Radiol 6(2):133–139

    Article  PubMed  Google Scholar 

  30. Umans HR, Cerezal L (2008) Anterior ankle impingement syndromes. Semin Musculoskelet Radiol 12(2):146–153. doi:10.1055/s-2008-1078702

    Article  PubMed  Google Scholar 

  31. Vaseenon T, Amendola A (2012) Update on anterior ankle impingement. Curr Rev Musculoskelet Med 5(2):145–150. doi:10.1007/s12178-012-9117-z

    Article  PubMed  Google Scholar 

  32. Wakeley CJ, Johnson DP, Watt I (1996) The value of MR imaging in the diagnosis of the os trigonum syndrome. Skeletal Radiol 25:133–136

    Article  PubMed  CAS  Google Scholar 

  33. Wu WT, Chen ZW, Zhou YC (2012) Clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers. Saudi Med J 33(10):1087–1092

    PubMed  Google Scholar 

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Conflict of interest

S. Tack, C. Boi, S. Spiga, L. Macarini, M. Rossi, V. Vinci and E. A. Genovese declare that they have no conflict of interest.

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The study described in this article did not include any procedures involving humans or animal.

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Correspondence to E. A. Genovese.

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Spiga, S., Vinci, V., Tack, S. et al. Diagnostic imaging of ankle impingement syndromes in athletes. Musculoskelet Surg 97 (Suppl 2), 145–153 (2013). https://doi.org/10.1007/s12306-013-0280-1

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  • DOI: https://doi.org/10.1007/s12306-013-0280-1

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