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Extra-articular sources of pain:
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Ankle instability
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Equinus contracture
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Peroneal tendon pathology
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Loose body
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Accessory bone
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Sural neuritis
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Subtalar joint pain
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Intra-articular sources of pain:
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Synovitis
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Chondromalacia
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Meniscoid lesions
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Fibrosis
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Osteochondral lesion
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Impingement exostosis
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Degenerative joint changes
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Diagnostic Tools:
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MRI
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CT-SCAN
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Stress Radiography
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Diagnostic injections
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Diagnostic arthroscopy
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Radiographic findings:
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Anterior tibial exostosis
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Talar neck exostosis
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Loose bodies
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Talar dome lesion
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Subchondral pitting
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Joint narrowing
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Diagnostic injections:
- Must perform prior to considering any arthroscopy
- Need to achieve at least 75% relief
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1. Inject medially.
2. Utilize 10cc of .5% Marcaine.
3. Have patient walk/run around for 20 minutes.
4. Patient will then grade their improvement.
5. Results of the injection are very representative of the type of relief that patients will have after surgery.
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A. Douglas Spitalny, DPM
ABPS Rearfoot/Ankle
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