Trabecular trauma of the talus and medial malleolus concurrent with lateral collateral ligamentous injuries of the ankle: Evaluation with MR imaging

Objective. The objective of this study was to elucidate the relationship between lateral collateral ligamentous injuries of the ankle (ankle sprain) and bone bruise (trabecular trauma) of the talus and/or malleoli in the patients with twisting injuries of the ankle. Design. Magnetic resonance studies of the ankle were retrospectively reviewed, focusing on the presence or absence of lateral collateral ligamentous injuries and the location of bone bruise in the talus and/or malleoli. Patients. Thirty-five patients with acute twisting injuries of the ankle were studied. Results and conclusion. Four patterns of bone bruise were found in 14 patients: (1) bone bruise in the talar dome equivalent to osteochondral fracture in two patients, (2) bone bruise in the posteromedial aspect of the talus and the medial malleolus singly or in combination in four, (3) bone bruise in the anteromedial aspect of the talus in six, and (4) bone bruise with a combination of the second and third patterns in two. The second pttern was associated with tear of the anterior talofibular (ATAF) ligament in all patients and injury of the calcaneofibular (CF) ligament in one out of four. The third and fourth patterns were associated with tears of both ATAF and CF ligaments in all patients. The identification of bone bruise was of value in indicating lateral collateral ligamentous injuries.