European Radiology

, Volume 13, Issue 8, pp 1836–1842 | Cite as

Multi-fasciculated anterior talo-fibular ligament: reassessment of normal findings

  • E. M. Delfaut
  • X. Demondion
  • N. Boutry
  • H. Cotten
  • H. Mestdagh
  • A. Cotten
Musculoskeletal

Abstract

The aims of this study were to (a) provide an accurate description of the anterior talo-fibular ligament (ATFL) multifasciculated feature by means of cadaver study, and (b) to further delineate contour and signal variations on MR images related to this feature in a group of asymptomatic subjects. After MR imaging, three cadaveric feet were frozen and cut in the coronal plane. The ATFL were harvested and sent to pathology. Another cadaveric foot was dissected. The MR imaging was performed in 3 healthy volunteers and 19 patients without pathology of the ATFL. For both cadaveric feet and subjects, MR imaging protocol consisted of axial and coronal proton-density (PD) and T2-weighted turbo-spin-echo (TSE) sequences (TR/TE: 3500 ms/17–119 ms). On MR images, ATFL signal and fascicle numbers were assessed, respectively, in the axial and coronal planes. Gross anatomy and pathology confirmed the ATFL bifasciculated aspect. On cadaveric coronal MR images, 3 of 4 ATFLs were bifasciculated and one of four was striated. On patients' coronal MR images, 2 of 22 of the ATFL were monofasciculated, 12 of 22 bifasciculated, and 8 of 22 striated. On axial MR images, 16 of 22 of the ATFL demonstrated a low signal intensity and 8 of 22 an intraligamentous subtle increased signal intensity. Two of 22 of the ATFL had contour irregularities. Isolated anterior talo-fibular intraligamentous signal abnormalities or contour irregularities on axial PD and T2-weighted MR images with an otherwise normal ATFL aspect on coronal MR images and no other MRI criteria for ankle sprain may reflect normal anatomy.

Keywords

Ankle Ankle anatomy Ligaments Ligament injuries MR imaging 

References

  1. 1.
    Hamilton WG (1989) Foot and ankle injuries in dancers. Clin Sports Med 7:143–169Google Scholar
  2. 2.
    Schneck CD, Mesgarzadeh M, Bonakdarpour A et al. (1992) MR imaging of the most commonly injured ankle ligaments. Part 2 Ligament injuries. Radiology 184:507–512PubMedGoogle Scholar
  3. 3.
    Bencardino J, Rosenberg ZS, Delfaut E (1999) MR imaging of sports injuries of the foot and ankle. Magn Reson Imaging Clin N Am7:131–149Google Scholar
  4. 4.
    McDermott EP (1993) Basketball injuries of the foot and ankle. Clin Sports Med 12:373–393PubMedGoogle Scholar
  5. 5.
    Sarrafian SK (1993) Syndesmology. In: Sarrafian SK (ed) Anatomy of the foot and ankle, 2nd edn. Lippincott, Philadelphia, pp 163–167Google Scholar
  6. 6.
    Rouvière H (1981) Articulations du membre inférieur. In: Rouvière H (ed) Anatomie humaine descriptive topographique et fonctionnelle, tome III. 11ème édition (3ème tirage). Révisée et augmentée par A Delmas. Masson, Paris, New York, pp 368–369Google Scholar
  7. 7.
    Schneck CD, Mesgarzadeh M, Bonakdarpour A et al. (1992) MR imaging of the most commonly injured ankle ligaments. Part 1. Normal anatomy. Radiology 184:499–506PubMedGoogle Scholar
  8. 8.
    Beltran J, Noto AM, Mosure JC, Shamam OM, Weiss KL, Zuelzer WA (1986) Ankle: surface coil MR imaging at 1.5 T. Radiology 161:203–209PubMedGoogle Scholar
  9. 9.
    Erickson SJ, Smith JW, Ruiz ME et al. (1991) MR imaging of the lateral collateral ligament of the ankle. AJR 156:131–136Google Scholar
  10. 10.
    Mesgarzadeh M, Schneck CD, Theranzadeh J et al. (1994) Magnetic resonance imaging of the ankle ligaments: emphasis on anatomy and injuries to the lateral collateral ligaments. Magn Reson Imaging Clin North Am 2:39–58Google Scholar
  11. 11.
    Muhle C, Frank LR, Rand T et al. (1999) Collateral ligaments of the ankle: high-resolution MR imaging with a local gradient coil and anatomic correlation in cadavers. Radiographics 19:673–683PubMedGoogle Scholar
  12. 12.
    Beltran J, Munchow AM, Khabiri H, Magee DG, McGhee RB, Grossman SB (1990) Ligaments of the lateral aspect of the ankle and sinus tarsi: an MR imaging study. Radiology 177:455–458PubMedGoogle Scholar
  13. 13.
    Link SC, Erickson SJ, Timins ME (1993) MR imaging of ankle and foot: normal structures and anatomic variants that may simulate disease. AJR 161:607–612Google Scholar
  14. 14.
    Chandnani VP, Harper MT, Ficke JR et al. (1994) Chronic ankle instability: evaluation with MR arthrography, MR imaging, and stress radiography. Radiology 192:189–194PubMedGoogle Scholar
  15. 15.
    Kerr R, Forrester DM, Kingston S (1990) Magnetic resonance imaging of foot and ankle trauma. Orthop Clin North Am 21:591–601PubMedGoogle Scholar
  16. 16.
    Rijke AM, Goitz HT, McCue FC, Dee PM (1993) Magnetic resonance imaging of injury to the lateral ankle ligaments. Am J Sports Med 21:528–534PubMedGoogle Scholar
  17. 17.
    Kreitner KF, Ferber A, Grebe P, Runkel M, Thelen M (1999) Injuries of the lateral collateral ligament of the ankle. Eur Radiol 9:519–524CrossRefPubMedGoogle Scholar
  18. 18.
    Erickson SJ, Cox IH, Hyde JS, Carrera GF, Strandt JA, Eastkowski LD (1991) Effect of tendon orientation on MR imaging signal intensity: a manifestation of the magic angle phenomenon. Radiology 181:389–392PubMedGoogle Scholar
  19. 19.
    Rubin DA, Tischkoff NW, Britton CA, Conti SF, Towers JD (1997) Antero-lateral soft tissue impingement of the ankle: diagnosis using MR imaging. AJR 169:829–835Google Scholar
  20. 20.
    Jordan LK, Helms CA, Cooperman AE, Speer KP (2000) Magnetic resonance imaging findings in antero-lateral impingement of the ankle. Skeletal Radiol 29:34–39PubMedGoogle Scholar
  21. 21.
    Farooki S, Yao L, Seeger LI (1998) Antero-lateral impingement of the ankle: effectiveness of MR imaging. Radiology 207:357–360PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • E. M. Delfaut
    • 1
  • X. Demondion
    • 1
    • 2
  • N. Boutry
    • 1
  • H. Cotten
    • 3
  • H. Mestdagh
    • 4
  • A. Cotten
    • 1
  1. 1.Department of Musculo-Skeletal RadiologyRoger Salengro Hospital, CHRU LilleLille CedexFrance
  2. 2.Department of Anatomy, Faculty of MedicineRoger Salengro Hospital, CHRU LilleLille CedexFrance
  3. 3.Pathology LaboratoryLilleFrance
  4. 4.Department of Orthopaedic SurgeryRoger Salengro Hospital, CHRU LilleLille CedexFrance

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