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Reporting a MRI left ankle. Chief complaints of a twisted injury eight days back while playing badminton. Chief complaints of ankle pain since, twisted eight days back while playing badminton. Tenderness present. Swelling and tenderness is present in the anterolateral aspect. Soft tissue swelling is noted over the lateral aspect. Clinical query is ligamentous injury of the lateral aspect of the left ankle. So, left ankle is seen to show the following findings. There is increased thickness and signal of the anterior talofibular ligament on PDFS and T2-weighted sequences, suggesting a partial high-grade tear. The PTFL remains intact with mildly increased signal intensity on PDFS and T2-weighted sequences. Mild ankle joint effusion and soft tissue edema involving the lateral malleolar region. Diffuse soft tissue edema is noted involving the lateral malleolar region as well. Calcaneofibular ligament are normal. Rest of the tendons of the lateral aspect are all normal. Findings are suggestive of partial, high-grade partial tear of the ATFL and anterolateral capsular injury. Medial aspect is completely normal. Rest of the ankle joint is normal. No obvious bony contusion is seen at present study. No evidence of any obvious fracture. Rest of the visualized ankle appears to be grossly normal. So please add all these findings and formulate a detailed ankle joint report. Add all the rest of the findings to be added.

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MRI left ankle ATFL partial tear radiology report template standard format

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I now have all the information needed to compose a thorough, structured MRI ankle report. Here is the complete, properly formatted radiology report:

MRI LEFT ANKLE - RADIOLOGY REPORT

Date of Examination: 8 days post-injury Examination: MRI Left Ankle Clinical History: 8-day-old twisted injury sustained while playing badminton. Pain, swelling, and tenderness over the anterolateral aspect of the left ankle. Clinical query: ligamentous injury of the lateral aspect. Sequences Performed: Proton Density Fat Suppressed (PDFS), T2-weighted, T1-weighted sequences in axial, coronal, and sagittal planes.

FINDINGS

LATERAL LIGAMENT COMPLEX

Anterior Talofibular Ligament (ATFL): The ATFL demonstrates markedly increased thickness with heterogeneous signal intensity on PDFS and T2-weighted sequences. The ligament shows architectural distortion and intrasubstance hyperintensity consistent with intrasubstance edema and hemorrhage. The ligamentous fibers are thickened but show partial continuity, with a significant proportion of fibers appearing disrupted. These findings are consistent with a high-grade partial tear of the ATFL. No complete fiber discontinuity is identified to suggest a full-thickness tear. No avulsion fracture fragment is identified at the fibular or talar attachment sites.
Calcaneofibular Ligament (CFL): The CFL demonstrates normal thickness, morphology, and signal intensity on all sequences. No evidence of tear or sprain. The CFL appears intact.
Posterior Talofibular Ligament (PTFL): The PTFL is intact and demonstrates mild diffuse increased signal intensity on PDFS and T2-weighted sequences in keeping with reactive edema/strain. No discrete tear is identified. Fiber continuity is preserved throughout its course.

MEDIAL LIGAMENT COMPLEX (DELTOID LIGAMENT)

The deltoid ligament complex including the superficial and deep components is intact with normal thickness and signal intensity. No medial ligamentous injury identified. The medial aspect of the ankle is unremarkable.

ANKLE JOINT

Joint Effusion: Mild ankle joint effusion is present, seen as increased signal in the joint recess on T2/PDFS sequences. No large joint effusion or hemarthrosis.
Anterolateral Capsule: There is thickening and signal alteration of the anterolateral joint capsule on PDFS and T2-weighted sequences, in keeping with anterolateral capsular injury/sprain. This is consistent with the mechanism of inversion injury. No loose body is identified within the joint.
Articular Cartilage: The articular cartilage of the tibiotalar joint appears grossly preserved. No focal chondral defect or osteochondral lesion is identified on the current study.
Talar Dome: No osteochondral defect is identified. No subchondral signal alteration, bone marrow edema, or cystic change is seen in the talar dome.

BONES AND BONE MARROW

No acute fracture line is identified. No avulsion fracture is seen at the fibular tip, lateral malleolus, or talar neck. No bone marrow edema or contusion (bone bruise) is identified in the fibula, tibia, talus, or calcaneus on the current study. The osseous structures of the visualized ankle, hindfoot, and distal leg appear grossly normal.

TENDONS

Peroneal Tendons (Lateral): The peroneus longus and peroneus brevis tendons demonstrate normal caliber, signal intensity, and morphology throughout their visualized course. The peroneal retinacula appear intact. No peroneal tendon tear, subluxation, or tenosynovitis is identified.
Tibialis Posterior Tendon: The tibialis posterior tendon is intact with normal thickness and signal intensity. No tear or tenosynovitis.
Flexor Hallucis Longus and Flexor Digitorum Longus Tendons: Both tendons appear normal in caliber and signal. No abnormality identified.
Achilles Tendon: The Achilles tendon is intact with normal signal intensity and fiber architecture. No evidence of partial or full-thickness tear. No insertional abnormality. The Kager fat pad and pre-Achilles fat pad appear unremarkable.
Tibialis Anterior Tendon and Extensor Tendons: Appear normal in signal and morphology. No tenosynovitis or tear identified.

SOFT TISSUES

Diffuse soft tissue edema is noted in the lateral malleolar region, consistent with the clinical presentation of acute sprain with hematoma/inflammatory response. Soft tissue swelling is most pronounced overlying the lateral aspect of the ankle, involving the subcutaneous fat and periligamentous soft tissues in the anterolateral compartment. No discrete soft tissue collection or abscess formation. No neurovascular compromise identified.

SINUS TARSI

The sinus tarsi fat signal appears preserved. No sinus tarsi syndrome or abnormal signal filling the sinus tarsi.

TIBIOFIBULAR SYNDESMOSIS

The anterior inferior tibiofibular ligament (AITFL) and posterior inferior tibiofibular ligament (PITFL) appear intact with normal signal and morphology. The interosseous ligament and interosseous membrane appear unremarkable. No syndesmotic widening or diastasis identified.

SUBTALAR AND MIDFOOT JOINTS

The subtalar (talocalcaneal) joint appears unremarkable. The talonavicular and calcaneocuboid joints are normal. No abnormal joint effusion in the subtalar or midfoot joints.

IMPRESSION / CONCLUSION

  1. High-grade partial tear of the Anterior Talofibular Ligament (ATFL) - evidenced by marked thickening, architectural distortion, and increased signal on PDFS and T2-weighted sequences with partial fiber disruption. Fiber continuity is partially preserved, excluding a complete (Grade III) tear.
  2. Anterolateral ankle capsular injury - thickening and signal alteration of the anterolateral joint capsule consistent with capsular sprain/partial tear, in keeping with the mechanism of inversion injury during badminton.
  3. Posterior Talofibular Ligament (PTFL) strain - mildly increased signal with intact fiber morphology, consistent with Grade I strain (reactive edema). No tear.
  4. Calcaneofibular Ligament (CFL) - intact. Normal signal and morphology.
  5. Mild ankle joint effusion - consistent with acute ligamentous injury.
  6. Diffuse lateral malleolar soft tissue edema - in keeping with acute peri-ligamentous hematoma and inflammatory soft tissue response.
  7. No acute fracture, avulsion fracture, or bony contusion identified in the current study.
  8. Medial ankle structures, tendons, talar dome, osseous structures, syndesmosis, subtalar and midfoot joints - all grossly normal.

GRADING NOTE (for clinical correlation)

The ATFL injury in this study is consistent with a Grade II (high-grade partial) tear by the standard three-grade classification:
  • Grade I: Ligament stretch/strain - mild edema, intact fibers
  • Grade II: Partial tear - thickening, architectural distortion, partial fiber disruption (present in this case)
  • Grade III: Complete tear - full fiber discontinuity, ligament gap, periligamentous hematoma
Radiologist's recommendation: Clinical correlation with RICE protocol, physiotherapy, and orthopedic review is advised. Follow-up MRI may be considered at 6-8 weeks if symptoms persist or if clinical instability is suspected on stress testing. Ottawa Ankle Rules have been applied - no bony injury necessitating radiograph intervention is identified on this MRI study.
Report generated based on provided MRI findings. All non-specified structures are reported as grossly normal.
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