Posterior tibiotalar ligament injury resulting in posteromedial impingement.
OBJECTIVE
To describe the imaging features of the normal anatomy and injury of the posterior tibiotalar ligament (PTTL) of the ankle in a group of patients presenting with posteromedial impingement.


METHODS
Twenty-five consecutive patients underwent imaging for posteromedial ankle pain following injury. All 25 patients were investigated with MR imaging, 17 with ultrasound and 5 with radionuclide bone scanning. Clinical data and surgical findings were correlated with the results of radiological investigation.


RESULTS
The PTTL demonstrated scar formation and a hypertrophic response consistent with previous injury in all 25 patients. Displacement or encasement of the surrounding tendons and their sheaths was often encountered (12/25). Bony avulsion was demonstrated in 5/25 occasions with ultrasound and 2/25 with MR imaging. Twelve patients underwent surgery, confirming the radiological findings.


CONCLUSIONS
Imaging can effectively evaluate the integrity of the PTTL in the context of ongoing posteromedial ankle pain.
Koulouris
George
G
Medical Imaging Department, Cabrini Private Hospital, Malvern, Victoria, Australia.
Connell
David
D
Schneider
Tim
T
Edwards
William
W
D000328:Adult; D016512:Ankle Injuries / Q000150:complications* / Q000473:pathology; D000843:Ankle Joint / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D006801:Humans; D006984:Hypertrophy; D007592:Joint Diseases / Q000209:etiology* / Q000473:pathology; D008023:Ligaments, Articular / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged