Ankle Pain, Ankle Ligaments Sprain - Everything You Need To Know - Dr. Nabil Ebraheim

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Case description

Dr. Ebraheim’s educational animated video describes conditions and treatment methods associated with pain of the ankle. High ankle sprain •A high ankle sprain is a sprain of the syndesmotic ligaments that connect the tibia and fibula at the ankle. •Diagnosis of syndesmotic injury is usually done by the use of external rotation stress view examination or CT scan. This patient may require surgery. Anterolateral impingment •Painful limitation of full range of ankle motion due to soft tissue or osseous (bony) pathology. •Soft tissue thickeneing commonly seen in athletes with prior trauama that extends into the ankle jint. •Arthroscopy of the ankle may be helpful . •Tibisl bone spur impinging on the talus can become a source of chronic ankle pain and limitation of ankle motion in athletes. Osseous (bony) spur on the anterior lip of tibia contacting the talus during dorsiflexion. The patient may need debridment of the spur. Ankle sprain •Pain that is anterior and around the fibula can usually be attributed to a ligament sprain. •Sprains result from the stretching and tearing (partial or complete) of small ligaments that can become damaged when the ankle is forced into an unnatural position. •Treatment includes immobilization, ice therapy, physical therapy and rarely surgery. •With ankle sprain, the patient will be able to walk, but it will be painful. With a fracture, the patient will be unable to walk. Pain that is posterior to the fibula can usually be attributed to an injury of the peroneal tendons. Lateral ankle pain •Patients with peroneal tendon problemes usually describe pain in the outer part of the ankle or just behind the lateral malleolus. •Problems mainly occus in the area where the tendons of the two muscles glide within a fibrous tunnel . Peroneal inflammation/ tendonitis •Tendons are subject to excessive repetitive forces causing pain and swelling. •Peroneal tendon subluxation •Usually occurs secondary to an ankle sprain with retinaculum injury. •Occurs with dorsiflexion and usually eversion of the ankle. Posterior anle pain Achilles tendonitis •Irritation and inflammation due to overuse. •Pain, swelling and tears within the tendon. •Achilles tendon can become prone to injury or rupture with age, lack of use or by aggressive exercises. •The Thompson test is performed to determine the presence of an Achilles tendon rupture. A positive result for the thompson’s test is determined by no movement of the ankle while squeezing of the calf muscles. Posterior ankle impingment •Os trigonum or large posterior process of talus (stieda syndrome) •Common among athletes such as ballet dancers. •May be seen in association with flexor hallucis longus tenosynovitis. Tarsal tunnel syndrome •Compression or squeezing on the posterior tibial nerve that produces symptoms of pain and numbness on the medial area of the ankle. •When conservative treatment methods fail, surgical treatment or tarsal tunnel release surgery may be needed. Posterior tibial tendon tears are one of the leading causes of failing arches (flatfoot) in adults. •Too many toes sign •Loss of medial arch height •Pain on the medial ankle with weight bearing Arthritis of the ankle joint •Commonly the result of a prior injury or inflammation to the ankle joint. •Can usually be easily diagnosed with an examination and x-ray. Osteochondral lesion of the talus •Arthroscopic debridment may be necessary. 

tags: ankle pain Ankle ligaments sprain orthopedics ankle ligaments


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