Case study: Ankle joint effusion - Injection - NYSORA

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Case study: Ankle joint effusion – Injection

June 6, 2024

A 20-year-old man developed mild to moderate ankle pain after dancing. He has flat feet but no history of previous injuries. Although non-steroidal anti-inflammatory drugs (NSAIDs) provide him temporary relief, his pain keeps returning and has been worsening over the past month.

Physical examination

  • Medial and anterior ankle pain
  • Dorsal foot pain
  • No heel or Achilles pain
  • No increase in pain on provocative maneuvers
  • No edema or redness
  • No tenderness
  • Bilateral pes planus

Ultrasound findings

  • Synovial thickening and effusion in the tibiotalar joint

Ultrasound examination of the dorsal aspect of the foot revealed synovial thickening and effusion in the tibiotalar joint.

  • Posterior tibial joint tenosynovitis

Ultrasound examination of the medial aspect of the foot revealed a thickened posterior tibial tendon with surrounding effusion.

Long-axis view of the posterior tibial tendon revealing neoangiogenesis within the tendon tissue along with effusion above the tendon.

Diagnosis

The patient was diagnosed with ankle joint effusion and posterior tibial tendinopathy. Ankle joint effusion, often referred to as a swollen ankle, involves the accumulation of excess fluids in the soft tissues surrounding the joint. This condition frequently results from infection, inflammation, trauma, or overuse.

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