Superomedial calcaneonavicular ligament
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The superomedial calcaneonavicular ligament is a stabilizer of the longitudinal arch of the foot and one of three components of the spring ligament complex 1,2.
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The superomedial calcaneonavicular ligament connects the sustentaculum tali with the superomedial part of the navicular bone. Its superficial surface contains a fibrocartilaginous gliding zone faced towards the head of the talus and runs deep to the posterior tibialis tendon 1,2. It serves as the distal insertion point for the tibiospring ligament.
The proximal insertion of the superomedial calcaneonavicular ligament is located at the anterior surface of the sustentaculum tali.
The superomedial calcaneonavicular ligament inserts at the superomedial part of the talar articular surface of the navicular bone bypassing the navicular tubercle 1.
The superomedial calcaneonavicular ligament can be visualized on ultrasound with the transducer placed parallel to the plantar surface just inferior to the medial malleolus with the foot externally rotated in dorsal extension. The ligament is then visualized as a hyperechoic fibrillary structure running deep to the posterior tibialis tendon 2.
On MRI the superomedial calcaneonavicular ligament is can be seen on coronal, axial and oblique axial images. The fibrocartilaginous gliding zone shows a higher signal than the rest of the ligament and lies directly deep to the adjacent posterior tibialis tendon and covers the talar head 3.
The superomedial ligament is the part most likely to be injured of the three components of the spring ligament complex.
- spring ligament complex injury
- midtarsal sprain
- flat foot deformity
- posterior tibialis tendon dysfunction
- 1. Taniguchi A, Tanaka Y, Takakura Y, Kadono K, Maeda M, Yamamoto H. Anatomy of the Spring Ligament. The Journal of Bone and Joint Surgery-American Volume. 2003;85(11):2174-8. doi:10.2106/00004623-200311000-00018 - Pubmed
- 2. Perrich K, Goodwin D, Hecht P, Cheung Y. Ankle Ligaments on MRI: Appearance of Normal and Injured Ligaments. AJR Am J Roentgenol. 2009;193(3):687-95. doi:10.2214/ajr.08.2286 - Pubmed
- 3. Alves T, Dong Q, Jacobson J, Yablon C, Gandikota G. Normal and Injured Ankle Ligaments on Ultrasonography With Magnetic Resonance Imaging Correlation. J Ultrasound Med. 2018;38(2):513-28. doi:10.1002/jum.14716 - Pubmed