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DICOM HelpSource: Local (us-east1-c)
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Demographics:
25 years old, Male
Indication:
Ankle injury
Findings
- Acute minimally displaced fracture of the posterior malleolus
- Widening of the medial clear space
- Soft tissue swelling about the ankle
Diagnosis
Maisonneuve fracture
Sample Report
Acute minimally displaced fracture of the posterior malleolus.
Widening of the medial clear space raises concern for deltoid ligament injury.
Recommend tibia/fibula radiographs to evaluate for associated proximal fracture.
Soft tissue swelling about the ankle.
Discussion
- Just like the radius and ulna, think about the tibia and fibula as a ring structure. If you see injury in one place (either fracture or joint subluxation) inspect the rest of the ring for additional injuries. If you only see widening of the medial clear space of the ankle mortise, make sure to get tibia/fibula radiographs to look for proximal fibular (Maisonneuve) fracture
Annotated Images & Illustrations
Medial clear space widening (red line compared to the normal blue line).
Subsequent tibia/fibula radiographs show a Maisonneuve fracture of the proximal fibula (red arrow).