What anatomical feature does the topline of a shoe primarily aggravate?

The topline of a shoe is designed to encircle the upper part of the foot and can significantly impact the surrounding anatomical structures, particularly around the ankle region. In this context, the lateral malleolus, which is the bony prominence on the outer side of the ankle, can be aggravated by the topline of a shoe.

When shoes have a harsh or rigid topline, or if the height of the shoe collar is excessive, it may lead to friction or pressure against the lateral malleolus during movement, especially with activities involving lateral motion or excessive ankle flexion. This can potentially cause discomfort or exacerbate conditions such as tendonitis or bursitis in the area.

The other anatomical features listed may not be directly affected by the topline of a shoe in the same way. For instance, dorsal exostosis, which relates to growths on the dorsal aspect of the foot, is more affected by the shoe's overall fit and width rather than the topline specifically. The medial cuneiform and posterior tibial tendon are less likely to be aggravated by the topline structure, as they are situated more medially and posteriorly, respectively, away from direct interaction with the shoe's topline. Thus, the connection between the