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Imaging-guided steroid injections may speed recovery from posterior ankle impingement
Patients noted a marked decrease in symptoms and stiffness immediately following bupivacaine anesthetic injections.
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Sonography-guided injections of steroids and anesthetics may allow athletes with ankle inversion injuries to "rapidly" return to sports activities, according to a retrospective study.
Philip Robinson, MD, and colleagues at the Leeds Teaching Hospitals in Leeds, England, reviewed their results performing the technique in 10 professional soccer players aged 22 to 30 years with no previous posterior ankle pain.
“In our practice, we see many professional athletes with this condition and we found that the majority of them were showing excellent response to this treatment,” Robinson, lead author of the study, said in a press release. “We decided to analyze the imaging features and injection results more rigorously for publication.”
Patients had been treated with rehabilitation following an initial inversion injury, which resolved anterior and lateral symptoms. All patients developed clinical posterior impingement and posterior pain resistant to conservative therapy 3 to 4 weeks after injury, which prevented them from returning to competition. Upon clinical evaluation, surgeons found posterolateral capsule thickening and synovitis involving an intact posterior talofibular ligament in all patients, according to the release.
All patients underwent ankle MRI after clinical examination. Surgeons then performed sonographically guided injections of steroids and bupivacaine into the posterior capsule abnormality.
The researchers found that all patients tolerated the injection procedure with no immediate or delayed complications. All patients also noted a marked decrease in symptoms and stiffness immediately following bupivacaine injection.
“For patients, the results of this study mean that they should have a faster recovery time and may not require arthroscopy. It also demonstrates that ankle impingement syndromes, which appear predominately soft tissue-based, can respond to image-guided injection treatments,” Robinson said in the release.
For more information:
- Robinson P, Bollen SR. Posterior ankle impingement in professional soccer players: Effectiveness of sonographically guided therapy. AJR Am J Roentgenol. 2006;187:W53-W58.