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