The Os Trigonum - An Unusual Cause of Ankle Pain

This accessory bone can cause issues when it becomes pinched between the heel and the ankle, especially during activities that involve pointing the toes downward, such as ballet, soccer, and certain types of dance. This condition is known as os trigonum syndrome, or posterior ankle impingement syndrome.

Symptoms of os trigonum syndrome include deep, aching pain in the back of the ankle, swelling, and tenderness. The pain typically worsens with activities that involve ankle plantar flexion (pointing the toes) and can be alleviated by rest.

Diagnosis of os trigonum syndrome usually involves a thorough clinical examination and imaging studies such as X-rays, MRI, or CT scans. These imaging techniques help visualize the os trigonum and assess its relationship with surrounding tissues.

Treatment for os trigonum syndrome often begins with conservative measures. Resting the affected ankle and avoiding activities that trigger pain are crucial. Ice therapy and anti-inflammatory medications can help manage pain and reduce swelling. Physiotherapy plays a significant role in treatment, focusing on exercises to strengthen the ankle and improve its range of motion.

In cases where conservative treatments fail to provide relief, more invasive options may be considered. Corticosteroid injections can reduce inflammation and provide temporary relief. In severe cases, surgical removal of the os trigonum may be necessary to eliminate the source of pain and restore full function to the ankle.

Proper diagnosis and tailored treatment are essential for managing os trigonum syndrome effectively. With appropriate care, individuals can return to their preferred activities without the hindrance of persistent ankle pain.