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Author: Amber MacFarlane, DO Affiliation: Crozer Health Sports Medicine, Springfield PA Co Author(s): David Baxter, DO Senior Editor: Wesley Troyer, DO Editor: Laura Mattson, DO
Clinical Vignette: 16 year old male high school football player presented with left ankle pain after sustaining an inversion injury with notable instability and physical exam findings concerning for high-ankle injury.
Image Interpretation: The AITFL was evaluated with noted loss of the continuity and linear contour of the ligament between its attachment points on the tibia and fibula with notable hypoechoic signal within this area tracking externally suggestive of fluid consistent with intra-articular fluid versus hematoma.
Teaching Pearl: This patient had physical exam concerning for syndesmotic injury with notable findings concerning for AITFL tear on US examination. These findings were confirmed on MRI with reported full thickness tears of AITFL and interosseous membrane, partial thickness PITFL tear and ATFL tear consistent with a Grade III syndesmotic injury. US examination of the AITFL provides significant clinical information to re-enforce clinical suspicion of a syndesmotic injury.
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