Ultrasound tutorial – Calcaneofibular Ligament Ultrasound

Anterior Calcaneofibular Ligament (CFL) ultrasound – Technique and Findings

Positioning

• Lateral decubitus

Ultrasound probe for the CFL

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

Finding the CFL

• Follow the peroneal tendons, the CFL runs underneath the tendons

Normal Appearance

• Consistent thickness
• Fascicular architecture

Pathology

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