Make an appointment
  • English
    • Français
    • Nederlands
Foot and Ankle Institute
  • Welcome
  • Disorders
  • Specialists
  • Publications
  • Info
  • Contact Us

Posterior impingement syndrome

Definition

You complain of pain at the back of the ankle joint.

 

Symptoms

The pain may be experienced as a shooting pain when descending a slope or a staircase, or as a pain in one specific spot at very specific movements.

Only rarely we find a restriction of movement. Unlike the front of the ankle joint, this region is much deeper and is covered with soft tissue, which impedes generating the known pains.

However, certain clinical tests, such as the sudden downward movement of the foot relative to the ankle, the rotation of the foot in maximum equinus position,… can generate the known pain.

fig-28

Yet, one should always look for cartilage injuries, beginning osteoarthritis, ligament lesions,… by means of additional examinations, such as a ct-scan without contrast.

 

Causes

Pain on the medial side can be caused by bone structures, which were torn off during previous trauma and/or by the narrowing of the channel, through which certain tendons must glide, with the result of inflammation. In other cases, especially when the pain is on the outside, the cause may be found in the presence of parts of the talus that are too voluminous.

fig-30
Fig-31

The pain is caused by inflammation of certain structures of the joint, which get chronically irritated by repetitive movements, often after experiencing a trauma, such as a “trivial” sprain or an ankle fracture. Typically this is also found in ballerinas who overload this part of the joint during the grand plie and demi plie.

 

Diagnosis

The diagnosis is mainly clinical, if one can generate the well-known pains. Additional examinations may include:

 

  • an X-ray;
  • a ct-scan with or without an intra-articular of cortisone in the joint if cartilage damage or loose fragments are suspected;
  • and/or a magnetic resonance.

Fig-32

 

Treatment

Initially, treatment is symptomatic. With the help of physical therapy, it is attempted to reduce the inflammation locally. In case of persistent pain, an injection in the painful area is suggested, with the aim of confirming the diagnosis once again, but mainly because it helps about 60% of the patients permanently.

In those patients whose symptoms unfortunately recur, despite an injection, arthroscopy may be proposed. The arthroscopic debridement of the back of the ankle joint is done through two small skin incisions, and this in day hospital.

Fig-33
Fig-34

Postoperative policy

To avoid that the hematoma, which inevitably develops after surgery, will cause the same symptoms, it is strongly recommended to move the ankle into the extremes of movement immediately after waking up.

One can also immediately lean on the ankle, except when a cartilage injury (6 weeks of non weight bearing) was operated.

  • Foot and Ankle Institute
    Building Ariane E0, Avenue Ariane 5
    1200 Woluwe-St-Lambert
    Tel: +32 2 280 17 07
    Email: info@footandankleinstitute.be
    Privacy Policy
  • Welcome
  • Disorders
  • Specialists
  • Publications
  • Info
  • Contact Us
  • English
    • Français
    • Nederlands
Corona COVID-19 Alert

 

Because of the increased risk of contamination, because of the hospital emergency plan, all consultations within the Foot and Ankle Institute are canceled from this Sunday 15/03/2020 until Friday 03/04/2020.

ONLY patients, in the immediate postoperative period, will be seen on the outpatient clinic. All surgeries, planned during this period, must be postponed. Our secretaries will contact you as soon as possible to ensure further treatment.

 

If you present yourself at the outpatient clinic, being part of the exceptions:

  • – Anyone, presenting respiratory symptoms, cough, fever, difficulty breathing or a flu syndrome will and has to be refused access to our facility, unless absolutely necessary regardin the continuity of care.
  • – The recommendations concerning hand hygiene and the means of preventing the spread of the virus must be respected at all times, as well during contact with the care provider as well as in the waiting room:
    • ° Do not shake hands
    • ° Wash your hands
    • ° Do not come if you experience respiratory symptoms,…
    • ° Respect always a minimum distance of 1-2 meter with other people
  • – Access to the facility is STRICTLY FORBIDDEN to children younger than 18 years old, except if they have been operated. If this is the case, maximum one accompanying person will be allowed.
  • – ONLY the patient will be granted access to the facility. No escorts, except in particular cases.

 

All surgeries are postponed according to the recommendations of the Minister of Health and all hospital directors. Our secretariat will contact you within reasonable time to fix a new dat with you, based on the development of the health situation, which is unknown and changing continuously.

The Foot and Ankle Institute would like to thank you for your understanding en encourages you to respect these safety instructions, put in place for the health of us all.

We are using cookies to give you the best experience on our website.

You can find out more about which cookies we are using or switch them off in settings.

 
Powered by  GDPR Cookie Compliance
Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly Necessary Cookies

Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.

If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.