Journal of Infectious Diseases and Medical Microbiology

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Review Article - Journal of Infectious Diseases and Medical Microbiology (2020) Volume 4, Issue 1

The ostrigonum syndrome: A diagnosis not to be missed- A Review

Gavvala Priyanka*
Department of Biotechnology, Osmania University, Hyderabad, Telangana, India

*Correspondence to:
Gavvala Priyanka
Department of Biotechnology
Osmania University

Accepted on November 09, 2021


The os trigonum is a triangular separate ossicle located at the posterior aspect of the talus close to the lateral tubercle. During plantarflexion, this ossicle and surrounding soft tissue become impinged between the posterior distal surface of the tibia and the superior surface of the calcaneus. The incidence of the os trigonum is 3 to 15%. Its bilateral form is more common than the unilateral one. This syndrome is found mostly in ballet dancers. Acute pain and swelling in the posterolateral aspect of the ankle are the characteristic elements of the os trigonum syndrome. Clinical examination findings can evok the possibility of this disease, but the diagnosis is confirmed by radiographs and Computed tomography showing the os trigonum. Magnetic resonance imaging may be used to rule soft tissue involvement. Initial treatment is conservative, when this later has failed to relieve the symptoms, surgical excision is indicated. The os trigonum syndrome refers to symptoms produced by pathology of the lateral tubercle of the posterior talar process. Pain can be caused by disruption of the cartilaginous synchondrosis between the os tnigonum and the lateral talar tubercle as a result of repetitive microtrauma and chronic inflammation. Additional etiologies include trigonal process fracture, flexor hallucis longus tenosynovitis, posterior tibiotalar impingement by bone block, and intraarticular loose bodies. This pictorial essay explores the role of imaging modalities in the diagnosis and treatment of the os trigonum syndrome, a symptom corn- plex that may present difficult diagnostic problems. The symptomatic os tnigonum has variously been named the os trigonum syndrome, talar compression syndrome, posterior ankle impingement syndrome, and posterior tibial talar impingement syndrome The symptoms of os trigo- num impingement include the chronic or the recurrent pain with stiffness, tenderness, and soft-tissue swelling in the posterior ankle. Strenuous activities that result in extreme plantar flexion such as ballet, soccer, football, and downhill running can cause compression of adjacent synovial and the capsular tissues against the posterior tibia. With repeated entrapment, the soft tissues tissues undergo inflammatory change with eventual thickening and fibrosis; associated flexor hallucis longus tenosynovitis may be present.


Cytomegalovirus is a very frequent virus. Once attacked, the virus remains in your circulation for the rest of your life. Because Cytomegalovirus rarely causes complications in healthy individuals, most people are unaware they have it. Cytomegalovirus is transmitted from one person to another through blood and other body fluids like saliva, urine, sperm, and breast milk. Although there is no treatment, there are drugs available to assist managing the signs. Cytomegalovirus is a cause for concern if you're pregnant or if your immune system is compromised. During pregnancy, women who have an active Cytomegalovirus infection can transmit the virus on to their kids, who may develop symptoms. In people with weaker immune systems, like those who have had an organ, stem cell, or bone marrow transplant, Cytomegalovirus illness can be lethal.

Signs and symptoms

Cytomegalovirus infection can cause no symptoms in the majority of healthy people. Some people just have modest symptoms. The following people are more prone to have signs and symptoms of Cytomegalovirus:

• Cytomegalovirus-infected new-borns that were infected before birth (congenital)

• Infected new-borns that are infected during or shortly after birth (perinatal). Babies who have been contaminated by breast milk are included in this group.

• People with impaired immunity, such as those who have undergone an organ, bone marrow, or stem cell transplant, or those who are HIV-positive.

Hearing impairment can affect, even babies who have no obvious symptoms. The most prevalent non-genetic cause of hearing loss after birth is Cytomegalovirus. These infections in children after the neonatal period seldom result in significant illness. However, some children may get pneumonia, hepatitis (liver infection), or a dermatitis. Infected older children and teenagers may experience single symptoms such as fatigue, muscle aches, headaches, fever, and a swollen liver and spleen. These symptoms are usually modest and last 2 to 3 weeks. In persons who had organ transplants or who have impaired immune function, Cytomegalovirus can cause dangerous infections. This viral infection can affect the lungs, neurological system, intestinal system, and eyes in people with AIDS, leading to loss of Vision.

Cytomegalovirus is not really accompanied by symptoms. If it occurs, the length of time symptoms last varies. This is dependent on how the disease occurs, as well as the person's age and physical wellbeing. A significant Cytomegalovirus infection prior to actually birth, for example, might cause behavioural delays throughout life. This viral infection in teenagers, on the other hand, may last till 2 to 3 weeks and create no long-term issues. When a person is infected, the virus remains dormant in the body. It can "reactivate" (reappear) weeks or years down the line. The resurfaced virus can cause severe sickness in those with severely reduced immune function (such as those with AIDS or those receiving chemotherapy). The majority of people, on the other hand, will never experience Cytomegalovirus symptoms again.

Cytomegalovirus can be transmitted in a variety of ways. Whoever has experienced this viral infection can transmit the virus to others, even if they don't show any symptoms. However, because the virus transmits through saliva, breast milk, vaginal fluids, sperm, urination, and faeces, this usually occurs through frequent proximity. Cytomegalovirus can also be detected in blood components and transplanted organs, which can lead to infection following a blood transfusion or organ transplant. However, organ-transplant patients receive preventive medications, and blood donors or banks have protocols in place to assist avoid Cytomegalovirus from spreading through blood transfusions.

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