MyPACS.net: Radiology Teaching Files > Case 3399386

previously visited ANTERIOR TALOFIBULAR LIGAMENT TEAR
Contributed by: Fritsch & Thompson, Radiologist, Diagnostic Radiology of Houston, Texas, USA.
Patient: 34 year old female
History:

Post traumatic ankle pain; r/o fracture and/or internal derangement.

Images:[small]larger

Fig. 1: RUPTURED A.T.F. LIGAMENT

Fig. 2: NORMAL A.T.F. LIGAMENT

Fig. 3

Fig. 4

Fig. 5

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Fig. 7

Fig. 8
Findings:

MRI examination reveals a complete full thickness tear of the anterior talofibular ligament (ATF). There is a high grade sprain of the lateral calcaneal fibular ligament. Posterior talofibular ligament remains intact. There is a significant amount of subcutaneous edema in the lateral and posterior aspect of the ankle. Peroneal tendons remain intact. Flexor hallucis is intact as is the flexor digitorum profundus. The tibialis posterior tendon shows linear high intensity signal changes distal to the medial malleolus with a prominent amount of tenosynovitis. There is a moderate effusion of the talonavicular joint with distension of its capsule. Effusion is also identified in the anterior and posterior talocalcaneal articulations. Sinus tarsi does not show any intrinsic abnormality. The extensor tendons are intact. Osseous elements of the hind foot and ankle do not show any fractures or marrow lesions. The achilles tendon is intact.

No fracture or bone lesions identified. Bone architecture is unremarkable. Alignment is intact. Joint spaces are well maintained. The soft tissue does not show any abnormal masses or calcifications.



Diagnosis:

MRI CONCLUSIONS:

  1. COMPLETE TEAR ATF.
  2. HIGH GRADE SPRAIN LATERAL CALCANEAL FIBULAR LIGAMENT.
  3. PARTIAL INNER SUBSTANCE TEAR TIBIALIS POSTERIOR DISTAL TO THE MEDIAL MALLEOLUS WITH ASSOCIATED PROMINENT TENOSYNOVITIS.
  4. EFFUSION AND DISTENSION OF THE TALONAVICULAR AND TALOCALCANEAL JOINTS.
  5. PROMINENT POST TRAUMATIC SUBCUTANEOUS EDEMA POSTERIOR AND LATERAL TO THE ANKLE.
X-RAY CONCLUSION:NO FRACTURE OR DISLOCATION OF THE LEFT ANKLE.

References: REFERRING PHYSICIAN: DR. EDWIN KIEKE, DC
Comments:
No comments posted.
Additional Details:

Case Number: 3399386Last Updated: 04-26-2009
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional Radiograph, MRAccess Level: Readable by all users
Keywords: atf,interior talofibular, ligament

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