The MR imaging features of the posterior intermalleolar ligament in patients with posterior impingement syndrome of the ankle

Skeletal Radiol. 1999 Oct;28(10):573-6. doi: 10.1007/s002560050621.

Abstract

Objective: To describe the MR imaging features of the posterior intermalleolar ligament (IML) in patients with posterior impingement syndrome (PIS) of the ankle.

Design and patients: Three patients (one male and two females, 13-25 years of age) are presented. Each patient presented clinically with symptoms of PIS of the ankle. Plain film examination was negative for a structural cause of the PIS in all patients. MR images were obtained with a 1.5 T scanner using an extremity coil. Clinical data and, in one patient, findings at ankle arthroscopy, were correlated with the results of MR imaging.

Results: Ankle MR images from the three patients with a clinical diagnosis of PIS are presented. Findings in all patients included: (1) absence of another structural cause of the PIS (i.e., an os trigonum, trigonal process, fracture, loose bodies, etc.), (2) identification of the IML as a structure discrete from the posterior talofibular and tibiofibular ligaments, and (3) prominence of the IML as indicated by (a) identification of the IML in three different imaging planes, and (b) a caliber of the IML comparable to that of the conventional posterior ankle ligaments visualized in the same imaging plane. Arthroscopic resection of a meniscoid IML resulted in resolution of the PIS in one of the patients presented.

Conclusions: MR imaging is an effective means of investigating the IML as a potential cause of PIS. The identification of a prominent IML in the absence of another structural cause of PIS indicates that impingement of the IML is the most likely cause of PIS.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Ankle Injuries / diagnosis*
  • Ankle Injuries / pathology
  • Ankle Joint / pathology*
  • Athletic Injuries / diagnosis
  • Dancing / injuries
  • Female
  • Humans
  • Ligaments, Articular / pathology*
  • Magnetic Resonance Imaging*
  • Male