0:01

Let's look at the anterior collateral ligaments

0:04

with the foot in the neutral projection.

0:07

You are emotionally, anatomically

0:10

anchored by the fibula.

0:12

See the peroneus brevis and

0:13

longus, so you should be oriented.

0:16

Tip of the foot here, back

0:18

of the foot or heel here.

0:20

We've got the anterior talofibular

0:23

ligament, the most commonly torn

0:25

ligament in the ankle right there.

0:28

That is the fibular attachment.

0:31

which hardly ever avulses.

0:33

It usually tears in the mid-portion,

0:35

or sometimes near the talus or neck.

0:39

And then up higher, we have the anterior tib-fib

0:42

ligament, which is more broad and fan-shaped.

0:45

You can see these on the T2, not

0:48

so much, or not so easily on the

0:50

proton density fat suppression image.

0:53

And then as we get up a bit higher,

0:56

we get into this syndesmotic membrane.

0:59

So these structures here are part of the high

1:03

ankle, so when you hear the term high ankle

1:05

sprain, that's what we're talking about.

1:08

Now let's scroll.

1:10

Here we are at the fibular tip.

1:12

Here's where we were.

1:13

Now let's go a little more deeply.

1:15

Look at what happens to your syndesmata complex.

1:17

It's very short.

1:18

It's very stubby.

1:19

It goes right into the tibia.

1:22

So now all you see is a black band.

1:24

Let's look at our anterior talofibular ligament.

1:27

It is coursing into the screen.

1:30

So it's curving away from you, so

1:32

you're not going to see it very easily.

1:34

In fact, that's the last you see

1:35

of it in the sagittal projection.

1:38

The value, though, of the sagittal projection

1:41

is that when you have injuries here, you can

1:42

see avulsions of the fibular tip, and if you

1:45

have a chronic tear, you, you'll develop a

1:49

mass, almost a meniscoid lesion right here,

1:53

that is oval in shape, that consists of

1:55

granulation tissue and scar, resulting in

1:58

anterolateral fibular gutter impingement syndrome.

2:04

Now let's take a look at the posterior

2:06

ligaments and the sagittal projection if

2:08

you have the time to see this next vignette.

Ankle MRI: Anterior Ligaments in Sagittal Plane

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Pro Tip: Click on a word in the transcript to jump to that point in the video

0:01

Let's look at the anterior collateral ligaments

0:04

with the foot in the neutral projection.

0:07

You are emotionally, anatomically

0:10

anchored by the fibula.

0:12

See the peroneus brevis and

0:13

longus, so you should be oriented.

0:16

Tip of the foot here, back

0:18

of the foot or heel here.

0:20

We've got the anterior talofibular

0:23

ligament, the most commonly torn

0:25

ligament in the ankle right there.

0:28

That is the fibular attachment.

0:31

which hardly ever avulses.

0:33

It usually tears in the mid-portion,

0:35

or sometimes near the talus or neck.

0:39

And then up higher, we have the anterior tib-fib

0:42

ligament, which is more broad and fan-shaped.

0:45

You can see these on the T2, not

0:48

so much, or not so easily on the

0:50

proton density fat suppression image.

0:53

And then as we get up a bit higher,

0:56

we get into this syndesmotic membrane.

0:59

So these structures here are part of the high

1:03

ankle, so when you hear the term high ankle

1:05

sprain, that's what we're talking about.

1:08

Now let's scroll.

1:10

Here we are at the fibular tip.

1:12

Here's where we were.

1:13

Now let's go a little more deeply.

1:15

Look at what happens to your syndesmata complex.

1:17

It's very short.

1:18

It's very stubby.

1:19

It goes right into the tibia.

1:22

So now all you see is a black band.

1:24

Let's look at our anterior talofibular ligament.

1:27

It is coursing into the screen.

1:30

So it's curving away from you, so

1:32

you're not going to see it very easily.

1:34

In fact, that's the last you see

1:35

of it in the sagittal projection.

1:38

The value, though, of the sagittal projection

1:41

is that when you have injuries here, you can

1:42

see avulsions of the fibular tip, and if you

1:45

have a chronic tear, you, you'll develop a

1:49

mass, almost a meniscoid lesion right here,

1:53

that is oval in shape, that consists of

1:55

granulation tissue and scar, resulting in

1:58

anterolateral fibular gutter impingement syndrome.

2:04

Now let's take a look at the posterior

2:06

ligaments and the sagittal projection if

2:08

you have the time to see this next vignette.

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Description

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Lesson

Foot & Ankle MRI Mastery Series: Pre-Course Activities

Lesson

Foot & Ankle MRI Mastery Series: Introduction

Lesson

Foot & Ankle MRI Mastery Series: Protocols and Sequences

Lesson

Foot & Ankle MRI Mastery Series: Anatomy

Lesson

Foot & Ankle MRI Mastery Series: Mid-foot Anatomy

Lesson

Foot & Ankle MRI Mastery Series: Case Review

Lesson

Foot & Ankle Masses

Ankle MRI: Anterior Ligaments in Sagittal Plane