Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 1;32(6):600-607.
doi: 10.1097/JSM.0000000000001021. Epub 2022 Feb 21.

Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes

Peta Baillie  1 , Katia Ferrar  2   3 , Jill Cook  2 , Peter Smith  4 , Jason Lam  3 , Susan Mayes  2   3
Affiliations

Posterior Ankle Impingement Syndrome Clinical Features Are Not Associated With Imaging Findings in Elite Ballet Dancers and Athletes

Peta Baillie et al. Clin J Sport Med. .

Abstract

Objective: To assess the association between clinical features and magnetic resonance imaging (MRI) findings in posterior ankle impingement syndrome (PAIS) and to compare the prevalence of imaging findings between participants with and without a clinical diagnosis of PAIS.

Design: Case-control study.

Setting: Elite ballet and sport.

Participants: Eighty-two male (54%) and female participants comprising ballet dancers (n = 43), cricket fast bowlers (n = 24), and football (soccer) players (n = 15).

Independent variables: Clinical: posterior ankle pain on body chart, passive plantarflexion pain provocation test. Patient-reported outcome measures: Oslo Sports Trauma Research Center Overuse Injury Questionnaire, Foot and Ankle Ability Measure Sports subscale.

Main outcome measures: Imaging findings including posterior ankle bone marrow edema, os trigonum (± bone marrow edema, and increased signal at synchondrosis), Stieda process (± bone marrow edema), talocrural and subtalar joint effusion-synovitis size, flexor hallucis longus tendinopathy, and tenosynovitis identified as present or absent on 3.0-Tesla MRI.

Results: Imaging findings were not associated with posterior ankle pain or a positive ankle plantarflexion pain provocation test. Imaging findings were not associated with patient-reported outcome measures. Imaging findings did not differ between PAIS-positive and PAIS-negative groups. Os trigonum and Stieda process were prevalent despite clinical status.

Conclusions: The lack of association between imaging findings and clinical features questions the role of imaging in PAIS. Clinicians should rely primarily on clinical assessment in the diagnosis and management of patients with PAIS.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Hamilton W. Pain in the posterior aspect of the ankle in dancers. Differential diagnosis and operative treatment. J Bone Jt Surg. 1996;78:1491–1500.
    1. Marotta JJ, Micheli LJ. Os trigonum impingement in dancers. Am J Sports Med. 1992;20:533–536.
    1. Peace KAL, Hillier JC, Hulme A, et al. MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases. Clin Radiol. 2004;59:1025–1033.
    1. Rietveld ABMB, Hagemans FMT, Haitjema S, et al. Results of treatment of posterior ankle impingement syndrome and flexor hallucis longus tendinopathy in dancers: a systematic review. J Danc Med Sci. 2018;22:19–32.
    1. Calder JD, Sexton SA, Pearce CJ. Return to training and playing after posterior ankle arthroscopy for posterior impingement in elite professional soccer. Am J Sports Med. 2010;38:120–124.

LinkOut - more resources