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Deltoid Ligament Injury
Julia R. Crim, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Medial clear space (a.k.a. medial ankle gutter): Radiographic interval between medial malleolus and medial talus
              • Pronation: Complex foot motion consisting of eversion, abduction, and rotation, resulting in depression of medial arch
              • Supination: Complex foot motion consisting 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

                                      1. Crim J et al: MRI and surgical findings in deltoid ligament tears. AJR Am J Roentgenol. 204(1):W63-9, 2015
                                      2. Jeong MS et al: Deltoid ligament in acute ankle injury: MR imaging analysis. Skeletal Radiol. 43(5):655-63, 2014
                                      3. Crim JR et al: Deltoid ligament abnormalities in chronic lateral ankle instability. Foot Ankle Int. 32(9):873-8, 2011
                                      4. Beals TR et al: Deltoid ligament injuries in athletes: Techniques of repair and reconstruction. Oper Tech Sports Med, 18(1), 1-10, 2010
                                      5. 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
                                      6. Mengiardi B et al: Medial collateral ligament complex of the ankle: MR appearance in asymptomatic subjects. Radiology. 242(3):817-24, 2007
                                      7. Hintermann B et al: Deltoid ligament injuries: diagnosis and management. Foot Ankle Clin. 11(3):625-37, 2006
                                      8. Hintermann B et al: Medial ankle instability: an exploratory, prospective study of fifty-two cases. Am J Sports Med. 32(1):183-90, 2004
                                      9. Hintermann B: Medial ankle instability. Foot Ankle Clin. 8(4):723-38, 2003
                                      10. Miller CD et al: Deltoid and syndesmosis ligament injury of the ankle without fracture. Am J Sports Med. 23(6):746-50, 1995
                                      11. 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
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Definitions

                                                  • Medial clear space (a.k.a. medial ankle gutter): Radiographic interval between medial malleolus and medial talus
                                                  • Pronation: Complex foot motion consisting of eversion, abduction, and rotation, resulting in depression of medial arch
                                                  • Supination: Complex foot motion consisting 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

                                                                          1. Crim J et al: MRI and surgical findings in deltoid ligament tears. AJR Am J Roentgenol. 204(1):W63-9, 2015
                                                                          2. Jeong MS et al: Deltoid ligament in acute ankle injury: MR imaging analysis. Skeletal Radiol. 43(5):655-63, 2014
                                                                          3. Crim JR et al: Deltoid ligament abnormalities in chronic lateral ankle instability. Foot Ankle Int. 32(9):873-8, 2011
                                                                          4. Beals TR et al: Deltoid ligament injuries in athletes: Techniques of repair and reconstruction. Oper Tech Sports Med, 18(1), 1-10, 2010
                                                                          5. 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
                                                                          6. Mengiardi B et al: Medial collateral ligament complex of the ankle: MR appearance in asymptomatic subjects. Radiology. 242(3):817-24, 2007
                                                                          7. Hintermann B et al: Deltoid ligament injuries: diagnosis and management. Foot Ankle Clin. 11(3):625-37, 2006
                                                                          8. Hintermann B et al: Medial ankle instability: an exploratory, prospective study of fifty-two cases. Am J Sports Med. 32(1):183-90, 2004
                                                                          9. Hintermann B: Medial ankle instability. Foot Ankle Clin. 8(4):723-38, 2003
                                                                          10. Miller CD et al: Deltoid and syndesmosis ligament injury of the ankle without fracture. Am J Sports Med. 23(6):746-50, 1995
                                                                          11. 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