Synovial impingement in the ankle. A new physical sign.
Inversion injuries of the ankle are common and most are managed adequately by functional treatment. A significant number will, however, remain symptomatic. Synovial impingement is one cause of continuing pain. This condition is often difficult to diagnose because the physical signs and investigations are non-specific. If the diagnosis is made, treatment by arthroscopic debridement has been shown to be highly effective. Our aim was to describe a new physical sign to help in the diagnosis of anterolateral synovial impingement in the ankle. A cadaver dissection demonstrated the anatomical basis for the physical sign and a prospective clinical study involving 73 patients showed that the lateral synovial impingement test had a sensitivity of 94.8% and a specificity of 88%. We describe the test and conclude that this physical sign will be of use to practitioners treating patients with chronic pain in the ankle after injury.
Molloy
S
S
Department of Orthopaedics, Princess Royal Hospital, Haywards Heath, Sussex, England, UK.
Solan
M C
MC
Bendall
S P
SP
D000293:Adolescent; D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000175:diagnosis*; D018771:Arthralgia / Q000209:etiology*; D001182:Arthroscopy / Q000379:methods; D003251:Constriction, Pathologic / Q000175:diagnosis; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010808:Physical Examination