Pain deep in the back of the ankle may come from a small extra bone called the os trigonum. This bone develops when a small section of the talus, the main ankle bone, remains separate as a child grows. Most people with this extra bone never experience symptoms. However, an ankle injury or repeated downward pointing of the toes may pinch the bone and nearby tissue. The resulting irritation is called os trigonum syndrome. Ballet dancers, soccer players, and runners face increased risk because their activities repeatedly place the ankle in positions that squeeze this area.

Symptoms include pain behind the ankle, swelling, and tenderness. Pointing the toes or pushing off the foot usually makes the discomfort worse. Some patients also notice stiffness that limits ankle movement. Pain may develop gradually with repeated activity or appear after an ankle sprain. Because these symptoms resemble Achilles tendon problems and other ankle injuries, an accurate diagnosis is important. A podiatrist reviews the patient's activities and injury history before examining the painful area. The examination includes checking ankle movement and locating tenderness. X-rays reveal the extra bone, while an MRI provides more detail about inflammation and nearby tissue. Finding an os trigonum on an X-ray alone does not prove it causes the pain.

Treatment focuses on relieving pressure and settling inflammation. A podiatrist may prescribe a walking boot to restrict painful ankle movement and protect the irritated area. Treatment also includes assessing whether a brace would provide appropriate support. Follow-up visits help the podiatrist track healing and guide a gradual return to activity. When symptoms persist, surgery to remove the extra bone offers another option. The podiatrist explains the procedure and expected recovery based on the patient's condition and activity goals. If you have symptoms of os trigonum syndrome, it is suggested that you schedule an appointment with a podiatrist for a diagnosis and appropriate treatment.

Some foot conditions may require additional professional care. If you have any concerns, contact one of our podiatrists of Mt Rose Foot & Ankle Specialists. Our doctors can provide the care you need to keep you pain-free and on your feet.

Rare Foot Conditions

The majority of foot conditions are common and can be treated by a podiatrist.  Standard diagnostic procedures are generally used to identify specific conditions and treatment can be rendered. A podiatrist also treats rare foot conditions which can be difficult to diagnose and may need extra attention and care. 

There are many rare foot conditions that can affect children. Some of these can include:

• Freiberg’s disease
• Kohler’s disease
• Maffucci syndrome

Freiberg’s disease - This can be seen as a deterioration and flattening of a metatarsal bone that exists in the ball of the foot. It typically affects pre-teen and teenage girls, but can affect anyone at any age. Symptoms that can accompany this can be swelling, stiffness, and the patient may limp. 

Kohler’s disease - This often targets the bone in the arch of the foot and affects younger boys. It can lead to an interruption of the blood supply which ultimately can lead to bone deterioration. The patient may limp or experience tenderness, swelling, and redness.

Maffucci syndrome - This affects the long bones in a child’s foot leading to the development of abnormal bone lesions. They are benign growths and typically develop in early childhood and the bones may be susceptible to breaking. 

A podiatrist can properly diagnose and treat all types of rare foot conditions. If your child is affected by any of these symptoms or conditions, please don’t hesitate to call our office so the correct treatment method can begin.

If you have any questions, please feel free to contact our office located in Reno, NV . We offer the newest diagnostic and treatment technologies for all your foot care needs.