From the Research
Yes, an obese 50-year-old male can suffer from os trigonum syndrome, as this condition is not exclusively limited to athletes or younger individuals, but can occur in anyone with the os trigonum bone, especially when it becomes irritated or inflamed due to various factors such as obesity, which places additional stress on the ankle joint during movement 1.
Causes and Risk Factors
Os trigonum syndrome is often triggered by activities involving repeated plantar flexion, such as walking downhill or wearing high-heeled shoes. In obese individuals, the natural biomechanics of walking may create more pressure on the posterior ankle area, increasing the risk of developing this syndrome. The presence of an os trigonum, a congenital bony anomaly, is a prerequisite for the development of os trigonum syndrome, and its incidence has been studied in various populations, including a significant incidence found in a study using computed tomography three-dimensional imaging 2.
Symptoms and Diagnosis
Symptoms of os trigonum syndrome typically include pain at the back of the ankle that worsens with activities, swelling, and difficulty pointing the foot downward. Diagnosis is based on clinical history, physical examination, and imaging studies such as X-rays or MRI, which can reveal the os trigonum and any associated soft tissue inflammation.
Treatment Options
Treatment usually begins with conservative measures, including:
- Rest
- Ice
- Anti-inflammatory medications like ibuprofen (400-800mg three times daily with food for 1-2 weeks)
- Physical therapy
- Possibly a walking boot or cast for immobilization
If conservative treatments fail after 4-6 weeks, corticosteroid injections or surgical removal of the os trigonum might be considered, especially if the condition significantly impacts mobility and quality of life, as discussed in recent literature reviews on the topic 1, 3. Surgical excision of the os trigonum has been successfully performed in cases where conservative management fails, allowing patients to return to their normal activities without recurrence of symptoms, as illustrated in case reports involving athletes 4.