Impingement tegn Ankel

The Ankle Impingement Sign is used to assess anterior ankle impingement, where soft tissues in front of the talocrural joint are compressed during dorsiflexion²․³. The test shows high sensitivity (94.8%) and specificity (88%)³․⁵, making it clinically useful in ankle evaluations.

Test Procedure

• Patient position: The patient sits while the therapist stands in front

• Therapist position:

  • One hand stabilizes the calcaneus laterally with the thumb placed over the anterolateral ankle

  • The other hand grips the forefoot

• Movement: The foot is moved from plantarflexion to full dorsiflexion while thumb pressure is applied over the anterolateral ankle²․³․⁵

• Positive test: Pain during dorsiflexion with thumb pressure

• Negative test: No increase in pain during movement²․³․⁵

Clinical Interpretation

During dorsiflexion, increased contact occurs between the tibia-fibula and the talus, which may compress surrounding soft tissues. This is especially relevant in cases of anterolateral or anteromedial ankle impingement²․³․⁵. The condition is commonly seen in athletes, particularly runners and dancers²․³․⁵.

Evidence and Clinical Relevance

Studies show that the Ankle Impingement Sign is a reliable clinical test for anterior ankle impingement, with both high sensitivity and specificity²․⁵. However, the test should be combined with imaging, such as MRI, for confirmation when needed²․⁵.

Sources:

1. Kyle P. Lavery, Kevin J. McHale, William H. Rossy & George Theodore. Ankle Impingement.Journal of Orthopaedic Surgery and Research volume 11, Article number: 97 (2016) 

2. Foot and Ankle Structure and Function. (2017, November 6). Physiopedia, . hentet 14:47, December 29, 2017 from https://www.physio-pedia.com/index.php?title=Foot_and_Ankle_Structure_and_Function&oldid=180503.

3. Houglum PA, Bertoti DB. Brunnstrom's clinical kinesiology. FA Davis; 2012

4. Malloy S, Solan MC, Bendall SP. Synovial impingement in the ankle. A new physical sign. J Bone Joint Surg Br 2003;85(3):330-333.

5. 
   

6. Flynn , Timothy. Users' Guide to Musculoskeletal Examination. USA: Evidence in Motion, 2008. Print.

7. https://www.thestudentphysicaltherapist.com/impingement-sign.html

8. Flynn TW, Cleland JA, Whitman JM. Users' guide to the musculoskeletal examination: fundamentals for the evidence based clinician. United States; Evidence in Motion:2008.