Journal of Foot and Ankle Surgery (Asia Pacific)

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  11 (2024)
Volume  10 (2023)
Volume  9 (2022)
Volume  8 (2021)
Volume  7 (2020)
Volume  6 (2019)
Volume  5 (2018)
Volume  4 (2017)
Volume  3 (2016)
Volume  2 (2015)
Volume  1 (2014)
Related articles

VOLUME 11 , ISSUE 3 ( July-September, 2024 ) > List of Articles

CASE REPORT

Stieda Process as a Source of Posterior Ankle Pain: A Case Report with Its Structural and Clinical Implication

Latif Z Jilani, Mohammad Istiyak, Yasir S Siddiqui

Keywords : Ankle pain, Case report, Os trigonum, Posterior ankle impingement, Stieda process

Citation Information : Jilani LZ, Istiyak M, Siddiqui YS. Stieda Process as a Source of Posterior Ankle Pain: A Case Report with Its Structural and Clinical Implication. J Foot Ankle Surg Asia-Pacific 2024; 11 (3):147-151.

DOI: 10.5005/jp-journals-10040-1351

License: CC BY-NC 4.0

Published Online: 03-07-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Posterior ankle pain commonly presents in young active populations. Several anatomical changes can cause posterior ankle pain like bony prominences, anomalous muscles, and ligament hypertrophies. An uncommon and unidentified cause of posterior ankle pain is the Stieda process (SP), an extended posterolateral talar process. In this case study, we discussed a 25-year-old young active female who is overweight having posterior ankle pain for the last 1 year. She was neither a dancer nor an athlete. The pain had no association with excessive plantar flexion. X-ray was advised which showed SP. The diagnosis was confirmed by magnetic resonance imaging (MRI). Conservative modality of treatment was tried first but the patient did not find much relief. So, an open surgical excision was done. At 6 months’ follow-up, the patient again had pain in the opposite ankle. An X-ray revealed the SP. Surgical excision with similar postoperative rehabilitation was followed. At 1-year follow-up, the patient had no pain with full range of motion (ROM) of bilateral ankles. We also discussed various differentials of posterior ankle pain.

PDF Share
  1. Yurgelon J, Jenning M. www.hmpgloballearningnetwork.com/site/podiatry/when-patients-present-posterior-ankle-impingement. Podiatry Today. 2016
  2. Cicek ED, Bankaoglu M. Prevalencia del proceso. talar posterior alargado (Proceso de Stieda) detectado por radio-grafía. Int J Morphol 2020;38(4):894–898. DOI: 10.4067/S0717-95022020000400894
  3. Rathur S, Clifford PD, Chapman CB. Posterior ankle impingement: os trigonum syndrome. Am J Orthop (Belle Mead NJ) 2009;38(5):252–253. PMID: 19584998.
  4. Symeonidis PD, Papakostas ET, Marín Fermín T, et al. Arthroscopic os trigonum en-bloc removal outcomes at 6-month follow-up are better compared to Stieda's process resection in patients with posterior ankle impingement syndrome: a prospective comparative study. J Isakos 2021;6(6):329–332. DOI: 10.1136/jisakos-2021-000619
  5. Ogut E. The Stieda process of the talus: the anatomical knowledge and clinical significance of an overlooked protrusion. Bull Natl Res Cent 2022;46:280. DOI: 10.1186/s42269-022-00968-w
  6. Robinson P, White LM. Soft-tissue and osseous impingement syndromes of the ankle: role of imaging in diagnosis and management. Radiographics 2002;22(6):1457–1469. DOI: 10.1148/rg.226025034
  7. Herring JA. Disorders of the foot. Tachdjian's Pediatric Orthopaedics: From the Texas Scottish Rite Hospital for Children. 2002. pp. 761–883.
  8. Weinstein SL, Bonfiglio M. Unusual accessory (bipartite) talus simulating fracture. A case report. J Bone Joint Surg Am 1975;57(8):1161–1163.
  9. Greisberg J. Core Knowledge in Orthopaedics: Foot and Ankle. Elsevier Health Sciences; 2007.
  10. Kalbouneh H, Alsalem M, Bani-Hani M, et al. A comprehensive study of the anatomical variations of the posterolateral tubercle of talus. Int J Morphol 2021;39(3):858–863. DOI: 10.21203/rs.3.rs-140532/v2
  11. Micheli LJ, Solomon R, Solomon J, et al. Posterior ankle decompression with os trigonum or stieda process resection in dancers: case series report and review of the literature. J Foot Ankle Surg 2021;60(4):706–711. DOI: 10.1053/j.jfas.2020.10.011
  12. Sanchez Prida N, Sanchez Dominguez P, Martin Fernandez A, et al. Assessment of ankle pain: posterior ankle impingement syndrome secondary to a Stieda process. Semergen 2016;42(8):e146–e148. DOI: 10.1016/j.semerg.2016.03.001
  13. Ecker ML, Ritter MA, Jacobs BS. The symptomatic os trigonum. JAMA 1967;201(11):882–884. DOI: 10.1001/jama.1967.03130110108037
  14. Fu X, Ma L, Zeng Y, et al. Implications of classification of os trigonum: a study based on computed tomography three-dimensional imaging. Med Sci Monit 2019;25:1423–1428. DOI: 10.12659/MSM.914485
  15. Perdikakis E, Karantanas A. Stieda process versus Haglund's deformity: an uncommon presentation of posterior ankle impingement. Open Med 2011;6(2):190–192. DOI: 10.2478/s11536-011-0001-9
  16. Ogut E. Is the third trochanter of the femur a developmental anomaly, a functional marker, or an evolutionary adaptation? Canadian Soc Forens Sci J 2022. DOI: 10.1080/00085030.2022.2104563
  17. Ribbans WOB, Ribbans H, Cruickshank J, et al. The management of posterior ankle impingement syndrome in sport: a review. Foot Ankle Surg 2015;21(1):1–10. DOI: 10.1016/j.fas.2014.08.006
  18. Nyska M, Howard CB, Matan Y, et al. Fracture of the posterior body of the talus—the hidden fracture. Arch Orthop Trauma Surg 1998;117(1-2):114–117. DOI: 10.1007/BF00703458
  19. Pereira VF, Gonçalves JP, Neves CMS, et al. Posterior ankle impingement syndrome in athletes: surgical outcomes of a case series. Sci J Foot Ankle 2019;13(1):15–21. DOI: 10.30795/scijfootankle.2019.v13.887
  20. Kushare I, Kastan K, Allahabadi S. Posterior ankle impingement-an underdiagnosed cause of ankle pain in pediatric patients. World J Orthop 2019;10(10):364–370. DOI: 10.5312/wjo.v10.i10.364
  21. Moore WL 3rd, Harger BL. Isolated stieda process fracture of talus: a case study. J Chiropr Med 2018;17(1):68–71. DOI: 10.1016/j.jcm.2017.11.001
  22. Martins N, Seixas MI, Couto M, et al. Posterior ankle impingement syndrome. Reumatol Clin (Engl Ed) 2018;14(4):244–245. DOI: 10.1016/j.reuma.2017.07.008
  23. Rogers J, Dijkstra P, Mccourt P, et al. Posterior ankle impingement syndrome: a clinical review with reference to horizontal jump athletes. Acta Orthop Belg. 2010;76(5):572–579. PMID: 21138209.
  24. Yilmaz C, Eskandari MM. Arthroscopic excision of the talar Stieda's process. Arthroscopy 2006;22(2):225.e1–225.e3. DOI: 10.1016/j.arthro.2005.11.004
  25. Sugimoto K, Isomoto S, Samoto N, et al. Arthroscopic treatment of posterior ankle impingement syndrome: mid-term clinical results and a learning curve. Arthrosc Sports Med Rehabil 2021;3(4):e1077–e1086. DOI: 10.1016/j.asmr.2021.03.013
  26. Ballal MS, Roche A, Brodrick A, et al. Posterior endoscopic excision of os trigonum in professional national ballet dancers. J Foot Ankle Surg 2016;55(5):927–930. DOI: 10.1053/j.jfas.2016.04.006
  27. Kudaş S, Dönmez G, Işık Ç, et al. Posterior ankle impingement syndrome in football players: case series of 26 elite athletes. Acta Orthop Traumatol Turc 2016;50(6):649–654. DOI: 10.1016/j.aott.2016.03.008
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.