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.

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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.

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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.

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Anterior Talo-Fibular Ligament (ATFL) Injury

MR imaging is excellent for the early detection and assessment of ligaments tears, bone contusions, stress and insufficiency fractures, osteochondral fractures, osteonecrosis, and transient bone marrow edema; for these reasons is considered as the modality of choice for assessment of pathologic conditions of the ankle and foot. But don’t forget the usefulness of dynamic ultrasound. If possible put an ultrasound device near the MRI room and always make a comparison between both imagine modalities.

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T2w (left) – Fast Stir (right) axial Mri scans (0.3 Tesla) of complete rupture of the ATFL

Dynamic Ultrasound scan of the same patient