Baylor Health Care System: Radiological evaluation of a high ankle sprain

	Past Issue: Volume 19, Number 4 • October 2006		Return to Table of Contents
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Radiological evaluation of a high ankle sprain

J. Mark Evans, MD, and William G. Schucany, MD

A 42-year-old woman with lateral left ankle pain presented to the orthopaedic clinic. She complained of unrelenting left ankle pain following a fall a week earlier. The plain radiographs of her left ankle revealed no evidence of fracture. Following her visit to the clinic, the orthopaedic surgeon ordered a magnetic resonance imaging (MRI) study of the left ankle. The T1- and T2-weighted images demonstrated an abnormal appearance of the anterior inferior tibiofibular (AITF) ligament as well as the anterior talofibular ligament (Figures 1-3). Marked subcutaneous edema was evident over the lateral and anterior left ankle. A small ankle effusion was also visualized.

What is the diagnosis and the most common mechanism of injury?

DIAGNOSIS: Acute distal tibiofibular syndesmotic injury of the left ankle, frequently referred to as a high ankle sprain. A commonly seen accompanying sprain of the anterior talofibular ligament is also present. The most common mechanisms of injury are external rotation of the ankle and hyperdorsiflexion (1).