FOIA MRI (Magnetic . Foot Ankle Clin. PMC A cause of chronic pain in the ankle after inversion sprain. Foot Ankle Clin. De Forced Dorsiflexion Sign is een orthopedische test om na te gaan of er sprake is van een voorste enkelimpingement. The Assessment E-Book The best way to spend 80euros. government site. It occurs when bone spurs, or osteophytes, develop on the front (anterior) aspect of the bones of the ankle. That is usually the journal article where the information was first stated. Careers. Talar impingement by the anteroinferior tibiofibular ligament. Keep going guys ! The Assessment E-Book This book is great! With one hand, the examiner grasps around and stabilizes the patient's heel, and with the other hand grasps the mid and forefoot on the plantar side from below . This can include X-rays of all sides of the ankle, or potentially an MRI. This condition, sometimes called "footballer's ankle," causes pain in the front of the ankle joint. Please enable JavaScript to pass antispam protection!Here are the instructions how to enable JavaScript in your web browser http://www.enable-javascript.com.Antispam by CleanTalk. The classic form of impingement is referred to as "footballer's ankle." Despite the name, this can happen in many different types of sports including soccer . Thank you! Anterior Ankle Impingement Beoordeling Anterieur enkel impingement is een aandoening waarbij sprake is van synoviale hypertrofie, kraakbeenproliferatie, littekenvorming . The more I read the more I learn. Disclaimer, National Library of Medicine Results: It was shown that the sensitivity of lateral radiographs for detecting anterior tibial and talar osteophytes was 40% and 32%, respectively (specificity, 70% and 82%). An official website of the United States government. Here is how to do it: https://youtu.be/b9cKgwnFIAw The forced dorsiflexion sign is a test proposed to help in the diagnosis of anterior ankle impingement SUPPORT THIS CHANNEL : http://bit.ly/SPPRTPT ARTICLES: Molloy et al (2003): https://www.ncbi.nlm.nih.gov/pubmed/12729103Visit our Website: http://bit.ly/web_PTLike us on Facebook: http://bit.ly/like_PTFollow on Instagram: http://bit.ly/IG_PTFollow on Twitter: http://bit.ly/Tweet_PTSnapchat: http://bit.ly/Snap_PT While pressure is applied with the examining thumb, the foot is brought from a plantarflexed position to full dorsiflexion. To conduct the test, have the patient in sitting position and grasp the calcaneus with one hand and use the thumb of that same hand to apply pressure over the anterolateral part of the ankle. The medial hand grasps the forefoot. The abnormal entrapment or contact of structures resulting in pain or restricted motion is impingement[1]. definetly a must have for every student, but it will also help an experienced practioner. }. Report of 14 cases. FA Davis; 2012. An oblique AMI radiograph is a useful adjunct to routine radiographs and is recommended to detect anteromedial tibial and talar osteophytes. The plain radiographs often are negative in patients who have anteromedial impingement. 2017 Mar;23(1):1-8. doi: 10.1016/j.fas.2016.01.005. Tibiotalar Impingement is a source of anterior ankle pain that is most often caused by osteophyte impingement in the anterior tibiotalar joint. A study by Stoller and colleagues3 found a 4% incidence of talar exostoses in a cohort of 100 asymptomatic subjects and a 59.3% incidence in 32 professional, or amateur, dancers. The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. padding: 2rem; Methods: 8600 Rockville Pike Ankle Impingement Stretches & Exercises for Pain Relief - Ask Doctor Jo - YouTube An ankle impingement can be anterior or posterior. The https:// ensures that you are connecting to the Positive test is pain reproduced from thumb pressure against joint and/or pain is greatest in dorsiflexion. . The anterior impingement test was originally described to detect labral lesions in patients with dysplasia. . Background: Current concepts review: Arthroscopic treatment of anterior ankle impingement. The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. Comparison between magnetic resonance imaging and clinical examination. Morphology of tibiotalar osteophytes in anterior ankle impingement. Anterior ankle impingement syndrome results from compression of structures during dorsiflexion at the anterior margin of the tibiotalar joint. Whether you're dealing with a posterior or anterior ankle impingement, quickly addressing your ankle injury with proper treatment will result in quicker recovery. Presence or absence of tibial and talar osteophytes on both radiographs was compared with the combined findings of CT, MRI scan, and arthroscopic surgery. Kyle P. Lavery, Kevin J. McHale, William H. Rossy& George Theodore. followers. Congrats to all the work you have put in there. Signs & Symptoms of Anterior Ankle Impingement, Interactive Content (Direct Video Demonstration, PubMed articles), Statistical Values for all Special Tests from the latest research, Currently on Version 5.0 Free lifetime updates. Available evidence reports; Anteromedial impingement of the ankle: using MR arthrography to assess the anteromedial recess. 2013 Nov 26;17(2):89-97. doi: 10.1007/s40477-013-0054-5. The anterior impingement syndrome of the ankle is a strangulation that can be caused by soft tissue, like the joint capsule or scar tissue, and hard tissue which refers to bone tissue. The Anterior drawer tests the integrity of the ATFL and the anterior joint capsule. The site is secure. An anterior drawer test for lateral ankle instability (Sen= .86 Spec= .74 +LR .22 and -LR .0018) . Berberian WS, Hecht PJ, Wapner KL, DiVerniero R. Foot Ankle Int. During the ankle impingement test, the patient is brought into this closed pack position, placing several connective tissues and muscles on passive tension. and transmitted securely. . Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. Anterior Ankle impingement is a condition involving synovial hypertrophy, cartilage proliferation, scar tissue formation, calcification, and or osteophyte formation in the anterolateral gutter. Best wishes from france. followers, 11.2k - pts who have persistent pain in anterior aspect of ankle & who have anterior tibiotalar spur evident on a lateral roentgenogram need additional diagnostic evaluation and management; - extreme dorsiflexion required by the demiplie position in ballet can lead to impingement of anterior lip of tibia on talar neck; Bethesda, MD 20894, Web Policies A lateral radiograph is insufficient to detect all anteriorly located osteophytes. GET ACCESS TO A FREE HEADACHE REHAB PROGRAM. Bring the patient from a plantarflexed position to a dorsiflexed position. Most patients report a history of these . The foot is subdivided into the rearfoot, midfoot, and forefoot. Please enable it to take advantage of the complete set of features! Accessibility Ross KA, Murawski CD, Smyth NA, Zwiers R, Wiegerinck JI, van Bergen CJ, Dijk CN, Kennedy JG. It often occurs when a bone spur develops on the front part of the ankle. In most cases Physiopedia articles are a secondary source and so should not be used as references. The Assessment E-Book Its an amazing Compilation! Skeletal Radiol. This increase was due to the high sensitivity of the oblique AMI radiographs for detecting anteromedial osteophytes (93% for tibial and 67% for talar osteophytes). 2006 Sep;11(3):663-83. doi: 10.1016/j.fcl.2006.06.003. When this occurs an athlete may develop symptoms from the . Users' guide to the musculoskeletal examination: fundamentals for the evidence based clinician. Absence of ankle instability, which you can assess with the anterior drawer test of the ankle. 21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL . This may involve resection or debridement of bony lesions, soft tissue lesions . 2010 Nov;2(6):495-502. doi: 10.1177/1941738110384570. Congrats guys youve done an incredible job. United States; Evidence in Motion:2008. AIS test should be positive: standing on both feet and leaning forwards, positive . Bekijk deze post om te leren hoe het uit te voeren! eCollection 2014 Jun. The closed pack position of the talocrural joint is full dorsiflexion. Conclusion: Anterior ankle impingement, more commonly known as footballer's ankle, is a form of chronic ankle pain caused by bone spurs, inflammation, or scar tissue on the front of the ankle bone. Anterior ankle impingement: Surgical goals for the treatment of anterior impingement involve removing the offending pathologic lesion contributing to the symptoms. Anterior drawer has sensitivity of 86 percent and specificity of 74 percent for a diagnostic test of 160 patients with an inversion ankle sprain when compared to an arthrogram. Totally worth it. While these stretches & exercises are mainly to help. Bookshelf Positive Test: Pain reproduced from combined movement with thumb pressureand pain is greater in dorsiflexion than in plantarflexion. Posterior ankle impingement (back of the ankle) Anterior ankle impingement (front of the ankle injury) is caused by constantly moving the foot upwards. Top Contributors - Melissa Billy, Admin, Chrysolite Jyothi Kommu, Adam Vallely Farrell, Kim Jackson, Eric Robertson, WikiSysop, Wanda van Niekerk, Evan Thomas and Vidya Acharya. . Diagnosis of anterolateral ankle impingement. Flynn TW, Cleland JA, Whitman JM. Spread the love and impact. The technical storage or access that is used exclusively for statistical purposes. Users' guide to the musculoskeletal examination: fundamentals for the evidence based clinician. https://www.physio-pedia.com/index.php?title=Foot_and_Ankle_Structure_and_Function&oldid=180503, https://www.youtube.com/watch?v=_xlwMP7Srw8, https://www.thestudentphysicaltherapist.com/impingement-sign.html, https://www.physio-pedia.com/index.php?title=Impingement_sign_ankle&oldid=268136. The impingement process begins when an inversion sprain tears the anterior talofibular, and/or the calcaneofibular ligament. margin-bottom: -6rem; When the lateral radiograph was combined with an oblique AMI radiograph, these figures increased to 85% and 73%, respectively (specificity decreased to 45% and 68%). A positive test result is when there is greater than 5 mm of anterior motion of the STJ as compared with the non-injured ankle. In some cases, diagnostic imaging tests may be necessary. Ankle impingement, once termed athlete's ankle or footballer's ankle, is one of the sources of chronic pain that athletes see on a regular basis. . Anterior Ankle impingement is a condition involving synovial hypertrophy, cartilage proliferation, scar tissue formation, calcification, and or osteophyte formation in the anterolateral gutter. British volume,85(3), 330-333. Curr Rev Musculoskelet Med. AAIS anterior ankle impingement syndrome, PAIS posterior ankle impingement syndrome aData are expressed as number of injuries and absence days per 1000 h with 95% condence interval I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. . When the patient is brought into full dorsiflexion the concave tibiofibular segment of the ankle mortise is brought into increased contact with the talus which creates a wedging or impinging effect. It functions as a rigid structure for weight-bearing and it can also function as a flexible structure to conform to uneven terrain. The assumed mechanism is that hypertrophic synovium is forced into the joint and impinges between the talus and lateral malleolus during forced dorsiflexion resulting in pain. It was shown that the sensitivity of lateral radiographs for detecting anterior tibial and talar osteophytes was 40% and 32%, respectively (specificity, 70% and 82%). We have to be careful with the interpretation of these results as the study is at risk of bias which is why we attribute this test a moderate clinical value. United States; Evidence in Motion:2008. https://wikism.org/w/index.php?title=Anterior_Impingement_Test&oldid=5592, Test for impingement of the talocrural joint of the, Patient is seated with legs hanging off the table facing examiner, Grasp the calcaneus with one hand placing the thumb over the anterolateral ankle, Bring the patient from a plantarflexed position to a dorsiflexed position, Positive test is pain reproduced from thumb pressure against joint and/or pain is greatest in dorsiflexion. [2][3], The talocrural joint is formed between the distal tibia-fibula and talus and is commonly known as the ankle joint. The .gov means its official. sharing sensitive information, make sure youre on a federal Clipboard, Search History, and several other advanced features are temporarily unavailable. Some advocate to the use of oblique radiographs to assess if bony spurring is medial or lateral 5. MRI. Radiographs often show spurs in the anterior distal tibia or dorsal aspect of the talus. followers, 274k The pain, swelling, and stiffness are caused by tissue irritation with plantar flexion, or pointing the toes. As the torn or ruptured ligament heals, the body forms too much scar tissue along the front and around the side of the ankle joint creating a meniscoid lesion. It's location is the anterior side of the ankle in the talocrural joint. Minimal data is available on the clinical significance of the Impingement ankle sign. Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP: iPhone/iPad: https://goo.gl/eUuF7w Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT B. Posterior ankle impingement test by Chris Frederick, PT 14,491 views Aug 12, 2017 97 Dislike Share Stretch To Win Institute 4.61K subscribers Chris Frederick, PT shows you the 3 ways to test. MeSH In one word: amazing. It is a hinge joint and allows for dorsiflexion and plantarflexion movements in the sagittal plane.[2]. Based on your symptoms, they can identify a pattern of pain and then carry out an Anterior Ankle Impingement test that involves the therapist dorsiflexing and externally rotating the ankle; pain provocation is indicative . 2002 Apr;31(4):214-21. doi: 10.1007/s00256-002-0477-0. Bones may be out of place on the front or the back of the ankle. Anterior ankle impingement (AAI) is characterised by anterior ankle pain, with or without restricted dorsiflexion.1, 2 The true incidence of AAI in the general population is not known. Awesome! The Mann-Whitney U test was used to compare days of absence for dierent injury categories. Consequently, use your other hand to move the foot into maximal dorsiflexion while you keep applying pressure with the other thumb. Ankle Impingement (Anterior) A common source of chronic ankle pain among athletes is anterior ankle impingement. Anterior ankle impingement syndrome results from compression of structures during dorsiflexion at the anterior margin of the tibiotalar joint[1]. Initially, the foot is held in plantarflexion. Synovial impingement in the ankle. J Bone Joint Surg Br 2003;85(3):330-333. An MRI can be helpful . Available from: Flynn TW, Cleland JA, Whitman JM. followers, 674k This test is done for anterior impingement of the talocrural joint of the ankle. Anterior Ankle Impingement Test or Hyperdorsi flexion Test is done with the patient sits on the edge of the examination table with the legs hanging down loosely and the knee bent 90. It is very structured and detailed. The distal and inferior aspect of the tibia known as the plafond is connected to the fibula via tibiofibular ligaments forming a strong mortise that articulates with the talar dome distally. Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP: iPhone/iPad: https://goo.gl/eUuF7w Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK http://bit.ly/GETPT This is not medical advice. Grasp the calcaneus with one hand placing the thumb over the anterolateral ankle. .addthis_inline_follow_toolbox { Estimates of test characteristics were obtained for 60 consecutive patients with an anterior ankle impingement syndrome. Clinician faces the patient in a seated position. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). the other hand grasps the forefoot. 2006 Jun;11(2):297-310, vi. The foot and ankle provide various important functions which include supporting body weight, providing balance, shock absorption, transferring ground reaction forces, compensating for proximal malalignment, and substituting hand function in individuals with upper extremity amputation/paralysis. Tibiotalar Impingement is a source of anterior ankle pain that is most often caused by osteophyte impingement in the anterior tibiotalar joint. Due to increased pain and swelling acutely, the anterior drawer test has been found . We use cookies to optimize our website and our service. An audible clunk may also be present during test. The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Anterior ankle impingement is a common clinical condition characterized by chronic anterior ankle pain that is exacerbated on dorsiflexion. Anterior Hip Impingement Test Posterior Hip Impingement Test Posterior Hip Impingement Test is useful to elicit pincer FAI pain. Oblique anteromedial impingement (AMI) radiographs were hypothesized to be a relevant adjunct, because of their utility to detect these anteromedially located osteophytes. Other additional tests including an MRI test, and an ultrasound or CT scan, may be carried out to confirm the diagnosis, and ensure that there are no other underlying problems. The foot and ankle form a complex system that consists of 28 bones, 33 joints, 112 ligaments, controlled by 13 extrinsic and 21 intrinsic muscles. . measured diagnostic accuracy of the anterior drawer test of the ankle in sixty-six . . The Student Physical Therapist. J Ultrasound. The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . Evidence. Introduction. Also known as ballet dancer's ankle, posterior ankle impingement is a less common condition characterized by compression of the structures in the back of the heel and ankle. Epub 2016 Feb 15. An Anterior Ankle Impingement can be diagnosed by a Physical Therapist using clinical tests following a clinical interview. Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. The hypothesis was that the application of a lateral radiograph is insufficient to detect osteophytes that are located in the anteromedial aspect of the ankle joint. When the lateral radiograph was combined with an . Youll propably find all the tests youve been looking for with propper explaination and source to doublecheck for you self. doi: 10.1016/j.fcl.2006.02.002. Most patients report a history of these traumas and report chronic anterolateral ankle pain and or limited dorsiflexion. The forced dorsiflexion test as described by Molloy et al. 2012 Jun;5(2):145-50. doi: 10.1007/s12178-012-9117-z. Milos RI, Fritz LB, Schueller-Weidekamm C. Radiologe. Unable to load your collection due to an error, Unable to load your delegates due to an error. [6][7]. How well the ankle can move; Tests: X-rays: This is the common way to see if there is an ankle impingement. Federal government websites often end in .gov or .mil. Its a result of trauma, specifically dorsiflexion trauma, ankle inversion trauma, or repetitive stress. A positive test results in the reproduction of your patients pain or if pain elicited by applying pressure with the thumb is increased. In this video I will be demonstrating how to perform the anterior ankle impingement test. If you are a patient, seek care of a health care professional. Diagnosis is made clinically with anterior ankle pain that worsens with forced dorsiflexion. Anterior Ankle impingement is a condition involving synovial hypertrophy, cartilage proliferation, scar tissue formation, calcification, and or osteophyte formation in the anterolateral gutter. As a result, the tibia and talus pinche them. Diagnosis is typically confirmed with plain radiographs. Houglum PA, Bertoti DB. The University College Copenhagen's Physiotherapy Programme uses this youtube channel to support our students skills in performing clinical examination metho. Ankle ligament reconstruction and surgical treatment of ankle impingement are reliably effective procedures. Moreover, the trochlear surface of the talus is wider anteriorly than posteriorly. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Other interesting wiki entries to help your diagnosis of ankle impingement are: Molloy, S., Solan, M. C., & Bendall, S. P. (2003). This site needs JavaScript to work properly. Joint osteophytes and cartilage proliferation may further limit ankle dorsiflexion. Medial impingement of the ankle in athletes. HELP TRANSLATE THIS VIDEO If you liked this video, help people in other countries enjoy it too by creating subtitles for it. 2001 Apr;22(4):313-7. doi: 10.1177/107110070102200407. It's a result of trauma, specifically dorsiflexion trauma, ankle inversion trauma, or repetitive stress. The ligamentous injury is not severe enough to cause chronic instability; however, inadequate immobilization and rehabilitation may lead to chronic inflammation in the ligament, resulting in formation of scar tissue. Impingement syndrome treatment Diagnosis is made clinically with anterior ankle pain that worsens with forced dorsiflexion. Clinically Relevant anatomy [edit | edit source] The foot and ankle form a complex system that consists of 28 bones, 33 . Arthroscopic excision of soft tissue overgrowths and osteophytes is an . Anterior impingement can follow a bad ankle sprain. Synovial impingement in the ankle: a new physical sign. Lavery KP, McHale KJ, Rossy WH, Theodore G. J Orthop Surg Res. (2017, November 6). Negative Test: Pain is not increased with combined movement. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Enroll in our online course: http://bit.ly/PTMSK The heel thrust test is a test to assess for posterior ankle impingement that persists after plantarflexion . Additional symptoms include instability; limited ankle motion; and pain with squatting, sprinting, stair climbing, and hill climbing. 2016 Sep 9;11(1):97. doi: 10.1186/s13018-016-0430-x. width: 100%; Anterolateral fibrous impingement of the ankle. Im looking forward to the lifelong updates on the topics. It works extremely well on my Macbook and iPad. Rebuilding ankle function is crucial and a well-rounded treatment plan should include appropriate ankle impingement exercises that focus on both flexibility and strength. Anterior ankle impingement results from an impingement of the ankle joint by a soft tissue or osteophyte formation at the anterior aspect of the distal tibia and talar neck. Every physical or physiotherapist should own it. T2 fat sat or STIR sagittal images can be useful for demonstrating marrow edema, subchondral changes and synovial/soft tissue thickening. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Inferior tibiofibular syndesmosis: Tenderness The anterior ankle impingement syndrome is a clinical pain syndrome that is characterized by anterior ankle pain on (hyper) dorsiflexion. Foot Ankle Surg. Read more, Physiopedia 2022 | Physiopedia is a registered charity in the UK, no. This test is done for anterior impingement of the talocrural joint of the ankle. I find it very easy to read. Radiographs often show spurs in the anterior distal tibia or dorsal aspect of the talus. Treatments: The treatment of anterior ankle impingement is focused on relieving pain and decreasing inflammation in the affected area of the joint. Also for beginners! The Journal of Bone and Joint Surgery. official website and that any information you provide is encrypted Anterior and posterior ankle impingement. Ive learnd a lot of new things and my approach to therapy in general have totally changed. Anterior ankle impingement can be due to scar tissue and inflammation or bone spurs that form in the anterior (front) of the ankle joint and limit range of motion and can cause pain. This is because ligaments become thicker. If the foot is then moved into dorsiflexion the pain intensifies which is positive for synovial impingement. The amount of work you put behind this must have been absolutely huge. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); Subscribe now and download a free home exercise program for headaches designed by our headache expert Ren Castien. Anterolateral impingement test: Thumb pressure applied over the anterolateral gutter with the foot in plantarflexion will push any hypertrophic synovium into the joint causing pain. Results: Estimates of test characteristics were obtained for 60 consecutive patients with an anterior ankle impingement syndrome. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. The clinician grasps the calcaneus with the hand on the lateral side of the foot with fingers around the calcaneal tuberosity and thumb over the anterolateral portion of the ankle. HHS Vulnerability Disclosure, Help [2] In a prospective, blinded, diagnostic-accuracy study, Croy et al. Posterior Ankle Impingement Syndrome. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Epub 2002 Feb 28. The authors conducted an extensive research on assessment tests in manual therapy. 133k Great work, guys. Would you like email updates of new search results? The patient is positioned supine on the edge of the examination couch. This might already cause discomfort but is not considered a positive test. 2017 Apr;57(4):309-326. doi: 10.1007/s00117-017-0228-9. Before The content is intended as educational content for health care professionals and students. Sports Health. justify-content: center; When this happens, the athlete might end up developing bone spurs that impinge on each other at the ankle joint. Foot and Ankle Structure and Function. Malloy S, Solan MC, Bendall SP. Anterior ankle impingement, originally nicknamed "footballer's ankle" and later known as "athlete's ankle" is a source of chronic ankle pain seen in athletes. The diagnostic value of an oblique radiograph, in addition to a lateral radiograph, for detecting osteophytes in the anterior ankle impingement syndrome was evaluated in a prospective study. Anterior soft tissue impingement and mild bony impingement confined to the tibia can be treated arthroscopically, whereas more severe anterior bony impingement and any form of posterior impingement require an open procedure. Anterior ankle impingement is best appreciated on lateral ankle radiograph or sagittal view on CT. It often occurs secondary to direct trauma (impaction force) or repetitive ankle dorsiflexion (repetitive impaction and traction force). Oblique radiograph for the detection of bone spurs in anterior ankle impingement. Ankle Impingement Sign. A new physical sign. 1173185. The technical storage or access that is used exclusively for anonymous statistical purposes. An oblique view is recommended in these patients. display: flex; (2003) has a sensitivity of 94,8% and a specificity of 88%. You may also be asked to perform a simple ankle impingement test, which involves lunging forward keeping your heel on the . 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