Ankle Pain Differential Diagnoses

From WikiMSK

Differential Diagnosis

Ankle pain persistent following injury

  • Fractures - anterior process calcaneus, lateral process talus, posterior process talus (or, rare, os trigonum fracture), osteochondral lesion, tibial plafond chondral lesion, base of fifth metatarsal
  • Bony impingements - anterior, posterior, anterolateral
  • Atypical sprains - chronic ligamentous instability, medial ligament sprain, syndesmosis sprain (AITFL sprain), subtalar joint sprain
  • Tendon injuries - chronic peroneal tendon weakness, peroneal tendon subluxation/rupture, tibialis posterior tendon subluxation/rupture
  • Other - inadequate rehabiliation, chronic synovitis, sinus tarsi syndrome, complex regional pain syndrome type 1

Lateral Ankle Pain

Medial Ankle Pain

Posterior Ankle Pain

  • Midportion Achilles Tendinopathy (this includes tendinosis, paratendonitis, and partial tears)
  • Posterior impingement syndrome
  • Insertional Achilles Tendinopathy (including retrocalcaneal bursitis and haglund's disease)
  • Plantaris Tendinopathy
  • Sever's disease (adolescents)
  • Achilles bursitis
  • Accessory or low soleus muscle
  • Referred pain (neural structures, lumbar spine), and sural neuropathy
  • Achilles tendon rupture
  • Achilles tendinopathy due to inflammatory arthropathies