title: Posterior Ankle Impingement in Two Athletic Twin Brothers, Could Genetics Play a Role?
abstract: Pain posteriorly in the ankle can be caused by bony impingement of the posterolateral process of the talus. This process impinges between the tibia and calcaneus during deep forced plantar flexion. If this occurs it is called posterior ankle impingement syndrome. We report the case of 2 athletic monozygotic twin brothers with bony impingement posteriorly in the left ankle. Treatment consisted of ankle arthroscopy in both patients during which the symptomatic process was easily removed. At 3 months after surgery, both patients were completely free of pain, and 1 of the brothers had already returned to sports. The posterior ankle impingement syndrome is not a rare syndrome, but it has not been described in siblings thus far. That these 2 patients are monozygotic twin brothers suggests that genetics could play a role in the development of skeletal deformities that can result in posterior ankle impingement syndrome.
authors.affiliation: Orthopedic Surgery Resident, Slotervaart Hospital Amsterdam, Amsterdam, The Netherlands. Electronic address: Niels.bech@gmail.com.
authors.forename: Niels H
authors.initials: NH
authors.lastname: Bech
authors.affiliation: Orthopedic Surgery Resident, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Peter A J
authors.initials: PA
authors.lastname: de Leeuw
authors.affiliation: Orthopedic Surgeon, Slotervaart Hospital Amsterdam, Amsterdam, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Haverkamp
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005538:Football / Q000293:injuries; D020022:Genetic Predisposition to Disease; D006801:Humans; D015601:Injury Severity Score; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000235:genetics; D008297:Male; D020127:Recovery of Function; D018570:Risk Assessment; D012494:Sampling Studies; D013577:Syndrome; D013628:Talus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014430:Twins, Monozygotic
keywords: Stieda's process; ankle arthroscopy; genetics; os trigonum; posterior ankle impingement syndrome; skeletal deformity