Jeffrey Dalton Towers MD, Presenter: Nothing to Disclose

Derek R. Armfield MD, Abstract Co-Author: Nothing to Disclose

Kenneth Alan Buckwalter MD, Abstract Co-Author: Nothing to Disclose

James P Bradley MD, Abstract Co-Author: Nothing to Disclose

John Norwig MED, Abstract Co-Author: Nothing to Disclose

The diagnosis of high ankle sprain (syndesmotic tear) has significant consequences for treatment and return to play decisions in elite competitive athletes. Diagnosis can be confused with other injuries, particularly in football players with prior ankle injuries. We report the radiological and MRI finding of posterior malleolar periostitis in football players with high ankle sprains.

All candidates for professional football draft 2005 were screened by injury history, onsite history and physical exam. Imaging by plain radiographs or MRI was performed based on the clinical need for evaluation of injury history or reconciliation of onsite history and physical exam findings. 18 candidates had both a history of a high ankle sprain and either plain radiographs (16) or MRI (2). Plain radiographs were evaluated for the presence of subperiosteal new bone at the posterior malleolus of the tibia on the lateral projection. MRI exams were evaluated for posterior malleolar periosteal edema or elevation.

Of 16 radiographs, 12 had posterior subperiosteal new bone, and both MRI exams had posterior periosteal edema and elevation. Injuries were distributed relatively evenly among various position player.

Radiographic posterior malleolar periosteal new bone and the MRI finding of posterior malleolar periosteal stripping are frequently seen in high ankle (syndesmotic) injuries in elite football players

Towers, J, Armfield, D, Buckwalter, K, Bradley, J, Norwig, J, Posterior Malleolar Periosteal Injuries in Football Players with High Ankle Sprains.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4419539.html