Anterolateral Lateral Gutter

The ligamentous injury is not severe enough to cause chronic instability. The anterolateral recess of the ankle joint also known as the anterolateral gutter is a triangular or pyramidal formed topographical space of the anterolateral aspect of the ankle 1 4. These likely present sources of anterolateral gutter impingement.

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Panels a d show the left knee whereas panel e shows the right knee.

Anterolateral lateral gutter.

Anterolateral impingement of the ankle is a relatively uncommon cause of chronic lateral ankle pain produced by entrapment of abnormal soft tissue in the anterolateral gutter of the ankle 2 4. However inadequate immobilization and rehabilitation may lead to chronic inflammation in the ligament resulting in formation of scar tissue. The space may contain joint fluid in asymptomatic individuals and is defined by the following anatomical structures 1 4. The arthroscope is introduced through a high anterolateral portal while the limb is in the ﬁgure of 4 position.

The impingement process begins when an inversion sprain tears the anterior talofibular and or the calcaneofibular ligament. Ament lcl din the lateral gutter. Anterolateral impingement is thought to occur subsequent to relatively minor inversion injuries of the ankle. A e arthroscopic views of the lateral gutter structures when viewed from inside.

There is scar tissue and synovitis within the anterolateral gutter as well as a 5 mm osteochondral loose body. The osteochondral loose body likely originates from a full thickness sharply marginated chondral loss along the anterior aspects of the tibial plafond measuring 6 x 8 mm in dimension. Anterolateral impingement syndrome of the ankle is caused by entrapment of the hypertrophic soft tissue in the lateral gutter. The patient is supine.

It is an uncommon cause of chronic lateral ankle pain 6 typically seen in athletes 3 5. Anterolateral ankle impingement has been known under the term anterolateral meniscoid lesion which is the result of synovitis in the anterolateral gutter.

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