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A 27-year-old rugby player returns to clinic noting persistent ankle pain. He endorses a history of vague ankle issues but none that required missed competition time. His pain is located anteriorly and worsens when in a crouched position. Exam shows point tenderness at the anterior joint line, and passive dorsiflexion to 10° reproduces his pain. Which structure is unlikely to be a potential source of pain in this condition?
Anterior inferior tibiofibular ligament
Accessory ossification near the posterolateral talar process
Inflamed synovium and capsular tissues
Talar neck exostosis
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A 34-year-old active duty military officer has lateral right ankle pain with running during physical training that is worsening over the past 6 months. He recalls sustaining an ankle sprain 3 years ago that resolved with physical therapy. On examination the skin is intact and the talar drawer test is normal. He has pain anterolaterally with end-arc passive dorsiflexion and no pain posteriorly with passive plantarflexion. He has no tenderness on palpation at the distal fibula, anterior talofibular ligament, calcaneofibular ligament. An axial MR arthrogram of the ankle is shown in Figure A. What is the next most appropriate step in management following recalcitrant pain despite conservative management?
Ankle arthropscopy with synovial debridement
Open Brostrom ligament repair with Gould modification
Chrisman-Snook tendon transfer
Syndesmosis reduction and screw fixation
Ankle arthroscopy with loose body removal
The current body of available evidence supports the use of ankle arthroscopy for all of the following indications EXCEPT:
Debridement of diffuse degenerative ankle cartilage
Anterior ankle impingement
Loose body removal
A 28-year-old rugby player has had anterior ankle pain for several years. On physical exam he has painful and limited dorsiflexion of the ankle. Based on a dorsiflexed ankle radiograph shown in figure A, what is the most appropriate operative treatment?
Arthroscopic chondral drilling
Arthroscopic tibial debridement
Modified Brostrom procedure
Arthroscopic os trigonum excision
Arthroscopic tibiotalar arthrodesis