Differential Diagnosis for Lateral Ankle Pain (Chronic)
Single Most Likely Diagnosis
- Peroneal Tendinopathy: This condition is a common cause of lateral ankle pain, especially in individuals who participate in sports or activities that involve repetitive ankle movements. The peroneal tendons run along the lateral aspect of the ankle, and their inflammation or degeneration can lead to chronic pain in this area.
Other Likely Diagnoses
- Lateral Ankle Instability: Chronic lateral ankle instability can cause persistent pain due to repeated ankle sprains or the feeling of the ankle "giving way." This condition often results from inadequate healing of previous ankle sprains.
- Anterior Talofibular Ligament (ATFL) Injury: The ATFL is one of the ligaments on the lateral side of the ankle, and its injury can lead to chronic pain and instability if not properly treated.
- Os Peroneum Syndrome: This condition involves the os peroneum, a small bone embedded within the peroneus longus tendon. Fracture or irritation of this bone can cause lateral ankle pain.
Do Not Miss Diagnoses
- Osteochondral Lesion of the Talus: Although less common, an osteochondral lesion (a piece of cartilage and bone that becomes damaged) on the lateral aspect of the talus can cause chronic lateral ankle pain. Missing this diagnosis could lead to further joint damage.
- Ganglion Cyst: A ganglion cyst near the lateral ankle can cause chronic pain and should not be overlooked, as it may require surgical intervention.
- Nerve Entrapment (Superficial Peroneal Nerve): Entrapment of the superficial peroneal nerve can cause pain, numbness, and weakness on the lateral aspect of the ankle and foot.
Rare Diagnoses
- Haglund's Deformity: A bony enlargement on the posterior aspect of the calcaneus (heel bone) that can irritate the Achilles tendon and cause pain, although it's more commonly associated with posterior heel pain, it can sometimes refer pain to the lateral ankle.
- Intraosseous Ganglion Cyst of the Calcaneus: A rare condition where a cyst forms within the bone of the calcaneus, potentially causing chronic ankle pain.
- Tarsal Coalition: An abnormal connection between two or more of the tarsal bones in the foot, which can lead to chronic pain and stiffness in the ankle and foot, including the lateral aspect.