Posterior inferior tibiofibular ligament

Last revised by Dr Sachintha Hapugoda on 16 Mar 2022

The distal posterior inferior tibiofibular ligament (PITFL) is a strong ligament of the tibiofibular syndesmosis.

The posterior tibiofibular ligament is formed of multiple collagen bundles with interposed fatty tissue and courses obliquely downward from the posterior distal tibia to the posterior margin of the fibula, in a 20-40° angle to the horizontal plane 1. Proximally it blends with the posterior fibers of the interosseous ligament cranially. It has a triangular shape with transverse and oblique components 2.

  • proximal origin from the posterolateral tubercle of tibia (Volkmann)
  • distally converging insertion at the small posterior fibular tubercle

Hypointense in both T1 and T2 with interspersed fatty tissue.

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Cases and figures

  • Figure 1: lateral ligaments (Gray's illustrations)
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