Imaging Case of the Week 277 Answer

The AP view of the left ankle shows a widened medial ankle joint space, which is suggestive of a deltoid ligament tear.

The lateral ankle x-ray shows an undisplaced fracture of the posterior malleolus.

Teaching points:

  • The ankle joint space should be uniform. If the medial side is widened, suspect a deltoid ligament injury.
  • If there is an isolated fracture of the medial malleolus or a deltoid ligament tear on the ankle AP x-ray but a fracture of the lateral malleolus cannot be observed, image the entire leg to rule out higher fibular fracture, i.e. Maisonneuve fracture.



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