Talofibular Ligament Injury Workup

Updated: Apr 20, 2018
  • Author: Marc A Molis, MD, FAAFP; Chief Editor: Sherwin SW Ho, MD  more...
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Laboratory Studies

See the list below:

  • Laboratory studies are not indicated in the workup of ligamentous injuries of the ankle.

Related Medscape resource:

Resource Center Pathology & Lab Medicine


Imaging Studies

Indications for imaging studies in cases of suspected talofibular ligament injuries include the following:

  • Bony tenderness or deformity

  • Suspicion of a fracture or syndesmotic injury

  • Severe pain or swelling that makes the physical examination unreliable

  • Inability to walk

Initial radiologic studies of the ankle should include the following:

  • An anteroposterior (AP) view with the ankle in slight adduction

  • A true lateral view

  • A mortise view (45° oblique view with the ankle in dorsiflexion)

  • Consider stress views of the ankle.

  • If a syndesmotic injury is suspected, then AP and lateral views of the tibia and fibula should also be obtained to rule out associated fibular fractures.

Magnetic resonance imaging (MRI) may be useful in evaluating the soft-tissue anatomy of the ankle, such as ligaments and tendons. [12, 13]  This imaging modality is not typically an initial test performed, but MRI may be useful in the patient who is not healing, in whom a stress fracture is suspected, or in chronic ankle pain and instability.

A study with 25 participants reported that stress ultrasonography provides a safe, repeatable, and quantifiable method of measuring the talofibular interval and may augment manual stress examinations in acute ankle injuries. [14]

Related Medscape resource:

Resource Center Joint Disorders

Resource Center Pain Management: Pharmacologic Approaches

Specialty Site Radiology