Ultrasound tutorial – Anterior Talofibular Ligament Ultrasound

Anterior Talofibular Ligament (ATFL) ultrasound – Technique and Findings

Positioning

  • Lateral decubitus

Ultrasound probe for the ATFL

  • Hockey stick probe
    • Easiest to position
    • Good resolution
  • High frequency linear probe
    • Larger field of view
    • Sometimes difficult to position optimally

Normal Appearance

  • Consistent thickness
  • Fascicular architecture

Pathology

  • Sprain
    • Hypoechoic
    • Thickened
    • Loss of fascicular architecture
  • Tear
    • Partial/full thickness
      • Fluid (anechoic) extends into the tear