Medial clear space (a.k.a. medial ankle gutter): radiographic interval between medial malleolus and medial talus
Pronation: combination of eversion, abduction, and rotation, resulting in depression of medial arch
Supination: combination of inversion, adduction, and rotation, resulting in elevation of medial arch
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Relevant Anatomy
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Cooper MT: The role of deltoid repair and arthroscopy in ankle fractures. Clin Sports Med. 39(4):733-43, 2020
Crim J et al: MRI and surgical findings in deltoid ligament tears. AJR Am J Roentgenol. 204(1):W63-9, 2015
Jeong MS et al: Deltoid ligament in acute ankle injury: MR imaging analysis. Skeletal Radiol. 43(5):655-63, 2014
Crim JR et al: Deltoid ligament abnormalities in chronic lateral ankle instability. Foot Ankle Int. 32(9):873-8, 2011
Beals TR et al: Deltoid ligament injuries in athletes: techniques of repair and reconstruction. Oper Tech Sports Med, 18(1), 1-10, 2010
Chhabra A et al: MR imaging of deltoid ligament pathologic findings and associated impingement syndromes. Radiographics. 30(3):751-61, 2010
Cheung Y et al: MRI of isolated distal fibular fractures with widened medial clear space on stressed radiographs: which ligaments are interrupted? AJR Am J Roentgenol. 192(1):W7-12, 2009
Mengiardi B et al: Medial collateral ligament complex of the ankle: MR appearance in asymptomatic subjects. Radiology. 242(3):817-24, 2007
Hintermann B et al: Deltoid ligament injuries: diagnosis and management. Foot Ankle Clin. 11(3):625-37, 2006
Hintermann B et al: Medial ankle instability: an exploratory, prospective study of fifty-two cases. Am J Sports Med. 32(1):183-90, 2004
Miller CD et al: Deltoid and syndesmosis ligament injury of the ankle without fracture. Am J Sports Med. 23(6):746-50, 1995
Rasmussen O et al: Deltoid ligament. Functional analysis of the medial collateral ligamentous apparatus of the ankle joint. Acta Orthop Scand. 54(1):36-44, 1983
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KEY FACTS
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TERMINOLOGY
Definitions
Medial clear space (a.k.a. medial ankle gutter): radiographic interval between medial malleolus and medial talus
Pronation: combination of eversion, abduction, and rotation, resulting in depression of medial arch
Supination: combination of inversion, adduction, and rotation, resulting in elevation of medial arch
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Relevant Anatomy
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Cooper MT: The role of deltoid repair and arthroscopy in ankle fractures. Clin Sports Med. 39(4):733-43, 2020
Crim J et al: MRI and surgical findings in deltoid ligament tears. AJR Am J Roentgenol. 204(1):W63-9, 2015
Jeong MS et al: Deltoid ligament in acute ankle injury: MR imaging analysis. Skeletal Radiol. 43(5):655-63, 2014
Crim JR et al: Deltoid ligament abnormalities in chronic lateral ankle instability. Foot Ankle Int. 32(9):873-8, 2011
Beals TR et al: Deltoid ligament injuries in athletes: techniques of repair and reconstruction. Oper Tech Sports Med, 18(1), 1-10, 2010
Chhabra A et al: MR imaging of deltoid ligament pathologic findings and associated impingement syndromes. Radiographics. 30(3):751-61, 2010
Cheung Y et al: MRI of isolated distal fibular fractures with widened medial clear space on stressed radiographs: which ligaments are interrupted? AJR Am J Roentgenol. 192(1):W7-12, 2009
Mengiardi B et al: Medial collateral ligament complex of the ankle: MR appearance in asymptomatic subjects. Radiology. 242(3):817-24, 2007
Hintermann B et al: Deltoid ligament injuries: diagnosis and management. Foot Ankle Clin. 11(3):625-37, 2006
Hintermann B et al: Medial ankle instability: an exploratory, prospective study of fifty-two cases. Am J Sports Med. 32(1):183-90, 2004
Miller CD et al: Deltoid and syndesmosis ligament injury of the ankle without fracture. Am J Sports Med. 23(6):746-50, 1995
Rasmussen O et al: Deltoid ligament. Functional analysis of the medial collateral ligamentous apparatus of the ankle joint. Acta Orthop Scand. 54(1):36-44, 1983
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