Ankle Shelf Syndrome

definition

In which Shelf Syndrome is it a Inflammation and swelling of various folds of the mucous membrane. This is particularly common Shelf Syndrome, also Plica syndrome called on the knee in front, but there is also a similar variant on the ankle. There the Synovial skin or that too Ligamentum fibulotalare anterius to be affected.

causes

Like all joints, the ankle is also surrounded by a synovial skin. This is a smooth, thin joint skin. It produces the synovial fluid. This keeps the joint space supple and there is less friction when moving. At the same time, the synovial fluid contains important nutrients for supplying the cartilage and bones.

During the development of the embryo, the synovial membrane forms a membrane that normally recedes. In some cases, however, it persists and can then lead to discomfort. Shelf syndrome can affect the upper ankle. Furthermore, the anterior ankle ligament (Lig. Fibulotalare anterius) are irritated by overuse, repeated microtraumas or a congenital weak ligament. The ligaments that actually secure the ankle joint can become inflamed and swollen as a result. In addition to the aforementioned ligament, other ligaments around the ankle can also be affected. Due to the irritation and inflammatory reaction, there is a risk that the ligament will rupture or that bone changes such as osteophytes will develop. These are cartilaginous or bony neoplasms that can ultimately prevent the ligament from moving. As a result, there is a restriction of movement and increasing wear and tear on the ankle.

Athletes such as soccer players, joggers or other ball sports that can put extreme stress on the ankle are particularly affected by this syndrome.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
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Symptoms

The Shelf Syndrome includes several complaints at the same time. Overuse can cause inflammation. It is often accompanied by typical symptoms such as jointpain and swelling as well as one Overheating of the joint accompanied. In addition, the Irritation of the synovial skin to come to a swelling, which eventually Block jointn can. This can lead to a particularly strong stress uncomfortable pulling in the upper ankle come. In particular, this prepares Tightening the foot towards the shin (Dorsiflexion) the patient's problems. You may feel that movement is being blocked and sometimes feel rubbing as well.

Depending on how far that Shelf Syndrome is already advanced, the Symptoms vary. At a beginning Shelf Syndrome the complaints rarely occur and you have to significant stress on the joint come.

At a Shelf Syndrome in the later stage can already Movements like climbing stairs, Bicycling or running trigger the discomfort. The irritation of the synovial skin can cause a Excess synovial fluid come. This, together with joint inflammation, can also lead to a joint effusion, which is externally caused by a Swelling and tenderness makes noticeable. The irritation can also cause one progressive wear and tear of the articular cartilage (osteoarthritis) to be responsible. In some cases, especially if the cause is not treated, it can develop into osteoarthritis. The Symptoms can worsen or possibly remain permanent.

Diagnosis

After a detailed questioning of the doctor with regard to the complaints and their occurrence in the context of the anamnesis, this is Ankle joint examined more closely. The doctor first feel the joint all around and can do it Sensitivity to pressure with pain reaction and also identify changes such as joint effusion. In the further The course of the diagnosis can be an X-ray be carried out around too bony changes to see. The Magnetic resonance imaging (MRI) is also particularly suitable, because too Soft tissue structures can be represented better. In many cases, an arthroscopy is also done. This is one minor surgery, in which the joint is mirrored using appropriate devices and a small camera. So can Changes in the joint are better assessed be and at the same time can too Signs of wear and tear removed directly become. This often confirms the diagnosis.

therapy

Depending on how far that Shelf Syndrome is advanced, becomes a conservative or surgical treatment aimed at.

The conservative therapy includes the Protection of the joint with cooling and elevated storage of the foot to allow any inflammation and swelling to heal. You can also anti-inflammatory and pain reliever drugs (NSAIDs) to be taken to improve the symptoms.

At advanced shelf syndrome it may be necessary that the Synovial fold removed becomes, as it always comes back to one, especially in physically active patients Friction on cartilage and bones leads. Removal of the synovial skin (Synovectomy) during an arthroscopy often shows a rapid improvement in symptoms and recurring inflammation is prevented.