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Keywords:

  • impingement;
  • inversion sprain;
  • recess;
  • arthroscopy;
  • ankle pain

Impingement of the synovial fold of the distal tibiofibular joint (DTFJ) may contribute to the development of chronic ankle pain and disability after ankle inversion sprain. The morphology of the synovial fold of the DTFJ and recess is poorly understood. The purpose of this study was to describe and quantify the synovial fold and recess of the DTFJ. Thirty-three pairs of adult embalmed ankle joints were dissected and the presence, disposition, morphology, and dimensions of the synovial fold were determined in relation to the DTFJ and its recess. A synovial fold was present in all specimens examined and extended from the deep posterior tibiofibular ligament along the DTFJ line an average of 15.31 mm [standard deviation (SD), 4.42 mm]. The majority of synovial folds were elongated in shape with smooth borders and occupied more than two thirds of the DTFJ line. In 70% of ankles examined, the synovial folds were found to extend a mean of 20.05 mm (SD, 7.01 mm) from the DTFJ line into the recess where they were loosely attached to the fibular wall. In the remaining ankles, the synovial fold was limited to the DTFJ line leaving the recess devoid of a synovial fold. Intra-observer and inter-observer reliability of measurements was good to excellent (intra-class correlation coefficient, 0.61–0.99). An understanding of the morphology of the DTFJ synovial fold might help to explain ongoing ankle pain after injury, and why arthroscopic removal of the tissue might be therapeutic. Clin. Anat. 26:630–637, 2013. © 2012 Wiley Periodicals, Inc.