Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, deep-seated ankle pain localized to the talus, exacerbated by weight-bearing activities and impact. Reports intermittent mechanical symptoms including catching, locking, or giving way. History of remote ankle trauma or repetitive microtrauma noted. Pain is poorly localized but often described as aching, with occasional sharp episodes. No history of systemic inflammatory arthropathy.
Clinical Examination Findings
Inspection reveals minimal swelling or effusion. Palpation demonstrates tenderness at the talar dome, elicited via forced plantarflexion or dorsiflexion. Range of motion (ROM) is often preserved but may be limited by pain at terminal ends. Stability testing (anterior drawer, talar tilt) is typically negative unless concomitant ligamentous injury exists. Gait analysis shows antalgic pattern during push-off phase.
Treatment Protocol
Initial management includes activity modification, non-steroidal anti-inflammatory drugs (NSAIDs), and a period of non-weight bearing or protected weight bearing in a CAM boot. Physical therapy focused on proprioception and strengthening. Surgical intervention (arthroscopic debridement, microfracture, or OATS procedure) indicated for persistent symptoms or high-grade lesions on MRI.