Posttraumatic adhesive capsulitis of the ankle: arthrographic diagnosis

A disabling decrease in range of motion may be a sequelae of ankle trauma. This complication can result from secondary degenerative joint disease, osteochondrial fractures with loose bodies, or posttraumatic adhesive capsulitis. The latter entity is well recognized as a complication of shoulder injuries but is rarely described in other joints. Since adhesive capsulitis produces no specific plain film findings, the confirmation of this diagnosis depends on the usage of a contrast study. It is only recently that ankle arthrography has been utilized to differentiate between the various causes of a painful posttraumatic ankle. Once a diagnosis is established by arthrography, therapeutic efforts can be directed toward relieving the specific abnormality. Three cases of "frozen" ankles are presented. Two were the result of intracapsular fractures, while the third had previously sustained a severe injury of the soft tissue. The arthrographic findings included a decrease in the joint capacity, obliteration of the normal anterior and posterior recesses, and extravasation of contrast material along the needle track.