Soft tissue lesions of the ankle

These are difficult to diagnose without arthroscopy, despite careful assessment and investigation. They represent some 30-50% of lesions found within the ankle joint and are diagnosed and treated by arthroscopy.

Patients with such lesions present with a combination of pain, swelling, tenderness, locking and giving way.

On examination, one finds a combination of tenderness, wasting, swelling, restricted range and instability.

Investigations include XR, CT, MRI, arthritis tests. These all may be negative.

Classification
Congenital: plicae / bands
Excise

Traumatic: sprains, fractures, prior surgery
Excise generalised synovitis
Excise localised bands
Excise meniscoid lesions secondary to impingement