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MRI appearance of surgically proven abnormal accessory anterior–inferior tibiofibular ligament (Bassett’s ligament)

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Abstract

Objective

A thickened accessory anterior–inferior tibiofibular ligament (Bassett’s ligament) of the ankle can be a cause of ankle impingement. Its imaging appearance is not well described. The purpose of this study was to determine if the ligament could be identified on magnetic resonance imaging (MRI), to determine associated abnormalities, and to determine if MRI could be used to differentiate normal from abnormal.

Materials and methods

Eighteen patients with a preoperative ankle MRI and an abnormal Bassett’s ligament reported at surgery were found retrospectively. A separate cohort of 18 patients was selected as a control population. The presence of Bassett’s ligament and its thickness were noted. The integrity and appearance of the lateral ankle ligaments, talar dome cartilage, and anterolateral gutter were also noted.

Results

In 34 of the 36 cases (94%), Bassett’s ligament was identified on MRI. The ligament was seen in all three imaging planes and most frequently in the axial plane. The mean thickness of the ligament in the surgically abnormal cases was 2.37 mm, compared with 1.87 mm in the control with a p value = 0.015 (t test). Nine of the 18 abnormal cases (50%) had talar dome cartilage lesions as a result of contact with the ligament at surgery, with only 3 cases of high-grade defects seen on MRI. Fourteen of the 18 abnormal cases (78%) had of synovitis or scarring in the lateral gutter at surgery, with only 5 cases with scarring seen on MRI. The anterior–inferior tibiofibular ligament was abnormal or torn in 8 of the 18 abnormal cases (44%) by MRI and confirmed in only 3 cases at surgery.

Discussion

Bassett’s ligament can be routinely identified on MRI and was significantly thicker in patients who had it resected at surgery. An abnormal Bassett’s ligament is often present in the setting of a normal anterior–inferior tibiofibular ligament. The cartilage abnormalities and synovitis associated with an abnormal Bassett’s ligament are poorly detected by conventional MRI.

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Authors and Affiliations

  1. Department of Radiology, Cleveland Clinic, 9500 Euclid Avenue/A21, Cleveland, OH, 44195, USA

    Naveen Subhas

  2. Department of Radiology, Duke University Medical Center, P.O. Box 3808, Durham, NC, 27710, USA

    Emily N. Vinson, R. Lee Cothran & Clyde A. Helms

  3. Orthopedics and Rehabilitation, Womack Army Medical Center, Fort Bragg, NC, 28310, USA

    James R. Santangelo

  4. Division of Orthopedic Surgery, Duke University Medical Center, P.O. Box 2923, Durham, NC, 27710, USA

    James A. Nunley II

Authors
  1. Naveen Subhas
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  2. Emily N. Vinson
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  3. R. Lee Cothran
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  4. James R. Santangelo
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  5. James A. Nunley II
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  6. Clyde A. Helms
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Correspondence to Naveen Subhas.

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Subhas, N., Vinson, E.N., Cothran, R.L. et al. MRI appearance of surgically proven abnormal accessory anterior–inferior tibiofibular ligament (Bassett’s ligament). Skeletal Radiol 37, 27–33 (2008). https://doi.org/10.1007/s00256-007-0390-7

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  • DOI: https://doi.org/10.1007/s00256-007-0390-7

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