posterior talofibular ligament ( RID3024 )
The XR, prospectively read as normal, shows an ossicle in the malleolar fossa, between the Lat malleolus and the talus. On MRI, it is a smoothly corticated ossicle containing fatty marrow: clearly chronic. Most of the PTFL inserts on the ossicle, indicating chronic avulsion (red arrows), though far posterior fibers remain intact in both axial and Cor images. Pain was localized to the Gr I ATFL sprain. I have never seen fibular PTFL avulsion (maybe its seen me); I know the PTFL can avulse the lateral tubercle of the posterior talar process, but have not seen this avulsion reported.
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