Best Practice Case Studies-Case 112 Asset 6 Lateral Ankle

Video Transcription

Video Summary

The session is an “ultrasound cases” Friday focused on a lateral ankle case presented by Dr. Julia Euphrates (Columbia University). A reminder is given that in two weeks (Dec 4), Dr. Jake Sellin will present a medial ankle case.<br /><br />Case: a 40-year-old male physician with acute-on-chronic left lateral ankle pain after an inversion injury while running. Exam shows significant lateral swelling, tenderness over the ATFL and peroneal tendons, and reduced heel-raise endurance. X-rays show a small chronic avulsion density near the talofibular region.<br /><br />Dr. Euphrates reviews a structured lateral ankle ultrasound protocol (ligaments, peroneal tendons/retinacula, nerves; stress/dynamic maneuvers as tolerated), emphasizing complete exams and clear reporting. Ultrasound findings include ankle joint effusion distending the talofibular recess, thickened/hypoechoic but intact ATFL (chronic sprain) with cortical irregularity, normal AITFL/CFL, and peroneal pathology: tenosynovitis with hyperemia, suspected longitudinal split tear of peroneus brevis, and a thickened, partially torn superior peroneal retinaculum with dynamic peroneal tendon subluxation (improving at 4-week follow-up). Superficial peroneal and sural nerves appear normal.<br /><br />The talk concludes with reporting tips, billing rationale for complete studies, and Q&A on performing sonographic anterior drawer stress testing.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 2

Topic Ankle

Keywords

4th Edition

4th Edition, Case 2

Ankle

lateral ankle ultrasound

anterior talofibular ligament (ATFL) sprain

peroneus brevis longitudinal split tear

peroneal tenosynovitis with hyperemia

superior peroneal retinaculum partial tear

dynamic peroneal tendon subluxation

sonographic anterior drawer stress test