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Posterior Ankle Impingement

Posterior Ankle Impingement
An illustration of a posterior ankle arthroscopy showing a prominent os trigonum which has been resected.

Posterior ankle impingement is a condition which occurs with maximal ankle plantarflexion. It usually presents with posterolateral ankle pain. It is seen in dancers in the demi-pointe and full pointe positions, and footballers when leaving the ground in a jump and striking the ball in full plantarflexion. It is more common in patients with a prominent os trigonum. It can be associated with FHL tendinitis and snapping. It can be bony or soft tissue. The diagnosis is often made with an MRI. Treatment includes rest and activity modification and anti-inflammatories. Image guided steroid injections can be helpful in both diagnosis and improving pain. A failure to improve with conservative treatment is an indication for surgery. The usual surgical treatment is a posterior arthroscopic debridement. We regularly see dancers and footballers here at the A2F clinic with posterior impingement and are able to resolve most without the need for surgery.