The diagnosis of high ankle sprain (syndesmotic tear) has significant consequences for treatment and return to play decisions in elite competitive athletes. Diagnosis can be confused with other injuries, particularly in football players with prior ankle injuries. We report the radiological and MRI finding of posterior malleolar periostitis in football players with high ankle sprains.
METHOD AND MATERIALS
All candidates for professional football draft 2005 were screened by injury history, onsite history and physical exam. Imaging by plain radiographs or MRI was performed based on the clinical need for evaluation of injury history or reconciliation of onsite history and physical exam findings. 18 candidates had both a history of a high ankle sprain and either plain radiographs (16) or MRI (2). Plain radiographs were evaluated for the presence of subperiosteal new bone at the posterior malleolus of the tibia on the lateral projection. MRI exams were evaluated for posterior malleolar periosteal edema or elevation.
Of 16 radiographs, 12 had posterior subperiosteal new bone, and both MRI exams had posterior periosteal edema and elevation. Injuries were distributed relatively evenly among various position player.
Radiographic posterior malleolar periosteal new bone and the MRI finding of posterior malleolar periosteal stripping are frequently seen in high ankle (syndesmotic) injuries in elite football players