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The ankle joint marks the point of connection between the bones of the leg and those of the foot, and controls the raising and lowering of the foot. The ankle is often considered to comprise not only the ankle joint itself but also the structures surrounding it at the lower end of the leg and the beginning of the foot proper.
Its vascular and biomechanical properties make it susceptible to injury. This may partly explain a higher risk of stress fractures and osteonecrosis in this location. Athletes who run, cut and pivot are particularly susceptible to injuries in this area. It is known as the keystone of the foot [10] and injuries to it can be "exasperating." [11]
Middle age is the most common age of affection, females are more affected than males, and the occurrence is often bilateral. A clinical feature of this condition is pain in the back of the heel, which is more after rest. Clinical evaluation and lateral radiographs of the ankle are mostly enough to make a diagnosis of Haglund's syndrome. [2]
Depending on the area of entrapment, other areas can be affected. If the entrapment is high, the entire foot can be affected as varying branches of the tibial nerve can become involved. Ankle pain is also present in patients who have high level entrapments. Inflammation or swelling can occur within this tunnel for a number of reasons.
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Sagittal magnetic resonance images of ankle region: psoriatic arthritis. (a) Short tau inversion recovery (STIR) image, showing high signal intensity at the Achilles tendon insertion (enthesitis, thick arrow) and in the synovium of the ankle joint (synovitis, long thin arrow). Bone marrow oedema is seen at the tendon insertion (short thin arrow ...
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