Like the knee joint capsule, the ankle capsule has an additional cranial extension at the syndesmosis. Taken with the medial and lateral malleoli, it forms a rectangular socket, the ankle mortise (a.k.a. mortice 1).īeing a synovial joint, the ankle joint (between the ankle mortise and talar dome) is surrounded by a joint capsule. On the radiograph, the horizontal portion of the distal tibia parallel to the dome of the talus is the tibial plafond. Trace the bony cortex of the lateral and medial malleoli, posterior tibia, calcaneum and base of 5th metatarsalĪssess Bohler’s angle: two tangent lines drawn across the anterior and posterior borders of the calcaneus form an angle measuring 25-40° On the lateral view carefully look at the fibulaĪn oblique fibula fracture may be difficult to see Trace around the distal tibia and fibula on both viewsįractures may be accompanied by ligamentous injury and may be unstable Os subfibulare (distal to the tip of lateral malleolus) Os subtibiale (distal to the tip of medial malleolus) Specifically, check the tarsals and the base of 5th metatarsal.īeware of accessory ossicles - do not misdiagnose as fractures: The distal tibia and fibula articulate with each other at the distal tibiofibular joint which is more commonly referred to as the tibiofibular syndesmosis (or simply the syndesmosis).Īs with all films, check around each bone on the film looking at the cortex. The ankle is a synovial joint composed of the distal tibia and fibula as they articulate with the talus. The deltoid ligament is much stronger than the ligaments that support the lateral aspect of the ankle and this results in a relative difference between the degree of pronation and supination that can be achieved. Lateral: posterior talofibular, anterior talofibular and calcaneofibular ligaments The ankle has three main sets of ligaments: Like all joints, structural integrity is achieved by the ligaments that hold it together. ![]() If there is one break in the ring, look for a secondĪssess all soft tissue structures for any associated or incidental soft tissue signs Ligaments The ring structure of the ankle is made up of three bones (tibia, fibula and talus) and three ligaments (medial and lateral collateral ligaments and interosseous ligament) Upon identifying an abnormality, do not cease the review, put it aside and ensure to complete the checklist. Review the entire radiograph, regardless of perceived difficulty. ![]() ![]() The order in which you interpret the radiograph is a personal preference. A recommended systematic checklist for reviewing musculoskeletal exams is soft tissue areas, cortical margins, trabecular patterns, bony alignment, joint congruency, and review areas. Choosing a search strategy and utilizing it consistently is a helpful method to overcome common errors seen in diagnostic radiology.
0 Comments
Leave a Reply. |