Magnetic Resonance Imaging Findings and Potential Anatomic Risk Factors for Anterolateral Ankle Impingement in Children and Adolescents Suffering from Non-Overload Atraumatic Ankle Pain.

Background/objectives: To assess magnetic resonance image (MRI) findings in children and adolescents with atraumatic non-overload ankle pain and to identify potential anatomic risk factors.
Methods: In total, 310 MRIs of 6- to 20-year-old patients were evaluated regarding detectable ankle pathologies. A total of 147 patients (68 males; 79 females) suffered from atraumatic non-overload ankle pain. The findings were compared to a control group (163 patients: 89 males; 74 females), including patients with ankle trauma in the 4 weeks prior to MRI examination. A t -test for unpaired samples and a binary logistic regression model were used to identify significant differences between both groups and determine potential anatomic risk factors.
Results: In the group with atraumatic ankle pain, 95 patients (64.6%) showed at least one pathology. Anterolateral impingement of the upper ankle joint was found in 29 patients (19.7%). Its occurrence was significantly higher in atraumatic non-overload patients than in the control group ( p = 0.043). Moreover, a significant correlation between anterolateral impingement of the upper ankle and the presence of hindfoot valgus malposition ( n = 25; 17.0%) could be proven in atraumatic non-overload patients ( p = 0.035).
Conclusions: Anterolateral impingement of the upper ankle joint is frequently observed in children and adolescents suffering from atraumatic non-overload ankle pain, whereby a hindfoot valgus malposition seems to present an anatomic risk factor.