During an ankle sprain, there can be stretching and tearing of the lateral ankle ligaments.
During an ankle sprain, there can be stretching and tearing of the lateral ankle ligaments. Use of diagnostic ultrasound can help diagnose the ligament injury. The anterior talofibular ligament is one of the most frequent ligaments injured during a lateral ankle sprain.
The other commonly evaluated ligament with ultrasound is the calcaneofibular ligament. Location of ankle ligaments Use of a linear probe (10-12 MHz) is typically used to evaluate the ankle. The most commonly injured ligament to assess first is the anterior talofibular ligament (ATFL).
A sprained ligament can appear hypoechoic and thickened, a torn ligament will show hypoechoic discontinuity, and a chronic tear may show heterogenous echogenicity with calcifications. The image below shows a torn ATFL and compares it to a normal ATFL. Torn ATFL Normal ATFL The ATFL is typically detected at the anterosuperior portion of the fibula.
The ligament traverses the distance between the distal fibula and the talus. Typically, palpation of the most distal aspect of the lateral malleolus will help find the ATFL. A dynamic stress can be applied across the ATFL by placing the ankle in plantarflexion and inversion.
ATFL anatomic photo The anterior inferior talofibular ligament (AiTFL) is visualized between the anterior fibular tubercle and the anterior portion of the distal tibia. The ligament can be stressed with dorsiflexion and external rotation. Ultrasound of Normal AiTFL Finally, the calcaneofibular ligament (CFL) can be found posterosuperior to the peroneal tubercle.
If you are experiencing symptoms that may be related to ultrasound evaluation of the lateral ankle complex, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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