Presentation
Left ankle inversion injury - 3 weeks ago. Lateral ankle pain, and swelling. Ankle radiograph negative for a fracture.
Patient Data
The anterior talofibular ligament shows three bands of different thicknesses. All three bands are hypoechoic but maintain continuity. No bony avulsion from the tibia/ talus.
The anterior inferior tibiofibular ligament and the calcaneofibular ligament show normal echopattern. No effusion in the anterior recess of the ankle joint.
'A' is the superior band of the anterior talofibular ligament. It is the thickest of all.
'B' is the middle band. It is thinner than the 'A' band and thicker than the 'C' band.
'C' is the inferior band and thinnest of all.
'A' and 'B' bands show a common proximal origin from the fibula. 'B' and 'C' bands have common insertion at the talus.
Case Discussion
The case shows anterior talofibular ligament sprain with an anatomical variant of three bands.