Posterior Tibiotalar Ligament Injury Resulting in Posteromedial Impingement

Objective: To describe the imaging features of the normal anatomy and injury of the posterior tibiotalar ligament (PTTL) of the ankle in a group of patients presenting with posteromedial impingement. Materials and Methods: Twenty-five consecutive patients underwent imaging for posteromedial ankle pain following injury. All 25 patients were investigated with MR imaging, 17 with ultrasound and 5 with radionuclide bone scanning. Clinical data and surgical findings were correlated with the results of radiological investigation. Results: The PTTL demonstrated scar formation and a hypertrophic response consistent with previous injury in all 25 patients. Displacement or encasement of the surrounding tendons and their sheaths was often encountered (12/25). Bony avulsion was demonstrated in 5/25 occasions with ultrasound and 2/25 with MR imaging. Twelve patients underwent surgery, confirming the radiological findings. Conclusion: Imaging can effectively evaluate the integrity of the PTTL in the context of ongoing posteromedial ankle pain.

Imaging of the rearfoot

The authors review various pedal conditions affecting the rearfoot, including plantar fasciitis, Achilles tendon pathology, fractures, arthritides, coalitions, and tumors. Various diagnostic imaging modalities such as routine radiography, radionuclide bone scanning, computed tomography, and magnetic resonance imaging are discussed.