0:00

I'm going to go to the back of the

0:01

ankle, the place where the ligaments

0:04

tear the least frequently, and just

0:06

focus on that right now at 3 Tesla.

0:10

So I'm posterior, you've got the fibula as a

0:14

landmark, and I'm going to go from high to low.

0:19

So I'm looking at the posterior ligaments, both

0:22

the low ankle ones and the high ankle ones.

0:26

So this is about posterior.

0:28

So let's start up high.

0:30

Up high, I'm going to draw, I've got this

0:34

ligament right here, which is known as

0:36

the posterior tib, tib, fib ligament.

0:41

Right below that, and a little more triangular

0:44

and a little more meniscoid looking, I'll

0:47

make it yellow right here, you can see it

0:49

a little better, is the inferior transverse

0:53

ligament of the tib-fib syndesmosis.

0:58

Then below that, I'll use another

1:00

color, we're working our way down.

1:03

We've got the intermalleolar

1:06

ligament, between the malleoli.

1:09

That's an oft-overlooked ligament, and that is a

1:12

ligament that can become entrapped with posture

1:14

impingement, and even bisected as kind of a bucket

1:19

handle tear situation, producing locking and

1:22

catching in the demi-pointe position for ballet

1:25

dancers, and that was described by Hamilton.

1:29

And then finally, we get down a little

1:31

bit lower, we'll pick another color.

1:34

Let's try blue.

1:36

And we get down to the posterior talofibular

1:39

ligament, which is part of the low ankle.

1:42

So, this intramalleolar ligament, you can see,

1:45

kind of bridges the high ankle and the low ankle.

1:48

And in many circles, this, and even in

1:51

some circles, this one right here, the

1:54

inferior transverse ligament, together,

1:56

are known as part of the crural system.

1:58

Because they bridge the high

2:00

ankle with the low ankle.

2:03

Now let's scroll and look at them.

2:06

And let's look at them on T1 first.

2:08

And There's the posterior tib-fib ligament,

2:13

there, and slightly more anterior to

2:16

it, in front of it, and below it, is

2:19

the inferior transverse tibial ligament.

2:23

Then the next ligament, which is seen better

2:25

on our water-weighted image to the right, but

2:27

it is here, is the intramalleolar ligament.

2:31

So you gotta work your way down.

2:33

And then finally, at the very bottom, you see it a

2:35

little better on the water-weighted image than you

2:37

do on the T1, but it's there, is the posterior

2:41

Talofibular ligament, which is

2:43

the back part of the low ankle.

2:45

So, low ankle, high ankle, and then

2:49

in between, the bridging, crural system.

2:53

That's the posterior aspect of the

2:55

ankle, and we're just getting started.