Chun-Hsien Huang1,2, Ming-Tung Huang2,3 and Cheng-Li Lin2,3*
1Department of Orthopedic Surgery, Show Chwan Memorial Hospital, Taiwan 2Department of Orthopedics, National Cheng Kung University Hospital, Taiwan 3Medical Device R&D Core Laboratory, National Cheng Kung University Hospital, TaiwanFulltext PDF
This is an uncommon case of ankle pain caused by chronic venous insufficiency which presented with periosteal reaction. The case is a 70-year-old woman with a medical history of hypertension and lung cancer. She came to our clinic for right ankle pain. X-rays revealed a periosteal reaction along the right distal tibia and fibula region. MRI showed non-specific infiltration and edema in the soft tissue around the ankle. Multiple lamellar depositions on the periosteum as an onion-feature were also found. Considering the clinical symptoms and the image findings, it was agreed that venous insufficiency induced the periosteal reaction. The causes of the periosteal reaction are broad and include tumors, trauma, infections, arthritis, drugs, or vascular problems. It is also known to be associated with CVI, but the exact pathophysiology is still unknown. This report aims to remind clinical physicians to be aware of such a rare cause and presentation of ankle pain.
Chronic venous insufficiency; Venous insufficiency; Periosteal reaction; Ankle pain; Periosteum
Huang C-H, Huang M-T, Lin C-L. Chronic Venous Insufficiency: An Unusual Cause of Ankle Pain Presenting with Periosteal Reaction. Ann Clin Case Rep. 2020; 5: 1869..