Os trigonum syndrome.

Area of Science:

• Orthopedics
• Sports Medicine
• Anatomy

Background:

• Os trigonum syndrome results from overuse injuries, specifically repetitive plantar flexion stress.
• It commonly affects ballet dancers and soccer players, presenting as posterior ankle pain during specific movements.
• The condition is often linked to pathology of the flexor hallucis longus tendon.

Purpose of the Study:

• To describe the etiology, diagnosis, and treatment of os trigonum syndrome.
• To highlight the role of imaging in diagnosing the condition.
• To outline both conservative and surgical management options.

Main Methods:

• Clinical diagnosis based on patient history and physical examination, focusing on pain during plantar flexion.
• Imaging studies, including lateral ankle radiography in maximal plantar flexion, to identify the os trigonum.
• Magnetic Resonance Imaging (MRI) to detect associated scar tissue when radiography is inconclusive.

Main Results:

• Radiography typically reveals the os trigonum between the posterior tibial lip and calcaneus.
• MRI may identify scar tissue behind the posterior talus, mimicking symptoms.
• Nonsurgical treatments like rest and physical therapy are initial management strategies.

Conclusions:

• Os trigonum syndrome is a clinical diagnosis exacerbated by plantar flexion activities.
• Imaging is crucial for diagnosis, with MRI useful when radiography is negative.
• Surgical excision of the os trigonum may be necessary for persistent symptoms in athletes, achievable via open or arthroscopic methods.