Anterior Tibiofibular Ligament Injury

In high impact sports sometimes an external ankle rotation happens, when the foot is turned towards the outside with respect to the leg, causing these types of tears.

Thanks to 3d4medical anatomy I created this picture showing most of the anatomical structures involved in this kind of traumas; don’t forget to examine also muscles and neurovascular bundles during your ultrasound exam; it’s no easy at the beginning, but with practice and a good atlas of anatomy, sure you can manage it.

This is the case of a professional football player with an high degree tear of the anterior inferior tibiofibular ligament.



The power-doppler ultrasound dynamic exam shows the hypervascularity of the painful site of injury.


Axial (left) and Coronal (right) T2 weighted Mri scans (0.3 Tesla) of the same patient.

Calcaneofibular Ligament Injury

There is usually a predictable kinematic pattern of injury involving the anterior talofibular ligament followed by the calcaneofibular ligament; don’t forget that finding a complete rupture of the calcaneofibular ligament means that also the anterior talofibular ligament must be injured.


Coronal (left) and Axial (right) T2 weighted Mri scans (0.3 Tesla) demonstrate a complete rupture of the calcaneofibular ligament.

The ultrasound imaging needs an accurate dynamic evaluation to demonstrate the injured ligament.

In this young professional football player both the anterior talofibular and calcaneofibular ligaments are completely torn.


Coronal (left) and Axial (right) T2 weighted Mri scans of the same patient: a complete rupture of the ATFL is evident.

The ultrasound dynamic investigation well defines the high degree injury of the ligament.