Patient History
17 M left ankle injury during football game
Findings
ARTICULATIONS:
Bone: No acute fracture or bony injury.
Tibiotalar joint: No arthropathy or osteochondral defects.
Hindfoot: Partial fibrocartilaginous coalition of the posterior subtalar joint. No arthropathy or chondromalacia.
Midfoot: No arthropathy or chondromalacia.
LIGAMENTS:
Anterior inferior tibiofibular ligament: Torn and detached from the anterolateral tibia (Chaput's tubercle) and lateral malleolus (Wagstaffe's tubercle). Discontinuous and irregular morphology increased intrasubstance signal.
Posteroinferior tibiofibular ligament: Intact.
Transverse ligament: Intact.
Interosseous membrane and ligament: High-grade sprain with increased intrasubstance signal.
Anterior talofibular ligament: High grade tear.
Posterior talofibular ligament: Intact.
Calcaneofibular ligament: High grade tear.
Deltoid ligament complex: Intact.
TENDONS:
Peroneus Longus/Brevis: Intact.
Posterior Tibialis: Intact.
Flexor Compartment: Intact.
Extensor Compartment: Diffuse edema.
GENERAL:
Muscles: Diffuse reactive sprain throughout the inferior extensor musculotendinous compartments.
Soft Tissue: Diffuse subcutaneous edema and periarticular soft tissue swelling.
Plantar Fascia: Intact.
Joint Effusion: Small tibiotalar joint effusion/hemarthrosis.
Intra-Articular/Loose Bodies: None.
Impressions
1. High ankle sprain with complete tears of the anterior inferior tibiofibular ligament, and high-grade sprain of the interosseous ligament and membrane. Minimal passive diastasis.
2. Diffuse subcutaneous edema and periarticular soft tissue swelling.
3. Small tibiotalar joint effusion/hemarthrosis.
4. High grade two part low ankle sprain/tears of the anterior talofibular lig and calcaneofibular ligament.
5. Anterolateral peroneal retinacular stripping but no peroneus longus or brevis dislocation.
