What Can Cause Persistent Ankle Pain after Inversion Sprains?


Inversion sprain of the ankle joint is very common.  Most of the time the pain resolves and one can resume normal sporting activities.

However, in some people. the pain may not totally go away.

There are 2 common causes of persistent pain that just simply won’t go away after an ankle inversion sprain.  The first is formation of scar tissue inside the ankle joint.  The other is an osteochondral lesion of the talar dome.

For example, this sportsman presented with persistent pain in the anteromedial aspect of his right ankle after an inversion sprain which happened 4 months ago.

X-ray of the right ankle appeared normal.

MRI scan showed an osteochondral lesion involving the superomedial aspect of the talar dome.

Superomedial Talar Dome Osteochondral Lesion

This diagnosis would have been missed if not for a high index of suspicion and by the use of an MRI scan.

Treatment consisted of an arthroscopic excision of the talar dome osteochondral lesion together with microfracture of the bony base to stimulate fibrocartilage formation.

Ankle Arthroscopy for Talar Dome Osteochondral Lesion

Ankle Arthroscopy with Microfracture of Talar Dome Bony Defect

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