Ultrasound - One week after the injury.
Multiple planes
Longitudinal
Transverse
Longitudinal
Transverse
Small effusion in the anterior ankle joint recess. Normal anterior inferior tibiofibularlar ligament. Thicker, hypoechoic anterior talofibular ligament bands with suspicious focal thinning. A calcaneal avulsed bone flake at the calcaneofibular ligament attachment site. Donor site defect is present. Both avulsed fragment and donor site defect are very well seen in two orthogonal planes. The affected ligament is edematous as compared to the asymptomatic side.
Cine-loops are aligned to the long and short axis of the calcaneofibular ligament. The ligament can still be taut on dynamic scanning (ankle varus tilt) favoring a few fibers still attached to the usual location.
Asymptomatic side cine-loops for comparison. It shows normal fibrillar echopattern of the ligament which makes it 'brighter' than the affected edematous 'darker' ligament.