Diagnostics
After a detailed questioning of the physician regarding the symptoms and their occurrence in the context of the medical history, the ankle joint is examined more closely. The physician first palpates the joint around the ankle and can determine pressure sensitivity with pain reaction and also changes such as joint effusion. In the further course of the diagnosis, an x-ray can be carried out in order to also see bony changes.
Magnetic resonance imaging (MRI) is also particularly suitable, as soft tissue structures can also be better visualized. In many cases, arthroscopy is also performed. This is a minor procedure in which the joint is mirrored using appropriate equipment and a small camera. In this way, changes in the joint can be better assessed and at the same time signs of wear can be removed directly. Often, the diagnosis is confirmed in this way.
Therapy
Depending on how advanced the shelf syndrome is, conservative or surgical treatment is sought. The conservative therapy includes the protection of the joint with cooling and elevation of the foot so that inflammation and swelling can heal.In addition, anti-inflammatory and analgesic drugs (NSAIDs) can be taken to improve the symptoms. In advanced shelf syndrome, it may be necessary to remove the synovial fold, as it repeatedly causes friction on cartilage and bone, especially in patients who are active in sports. Removal of the synovial skin (synovectomy) as part of arthroscopy often shows a rapid improvement in symptoms and prevents recurrent inflammation.
