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Tuesday Tip: MRI of the Proximal Tibiofibular Joint: How not to confuse the AnteroSuperior Ligament with the Biceps femoris tendon

Today’s Tuesday Tip continues with the Proximal TibioFibular Joint. On MRI at the Proximal TibioFibular Joint ( PTFJ) one thing that can be confusing is the tibial attachment of the Biceps Femoris Tendon which can be mistaken for the AnteroSuperior TibioFibular Ligament.

The Biceps Femoris tendon attaches predominantly to the fibula head but there is a component that

  1. Arises proximal to the fibula,
  2. Runs anteriorly and,
  3. Attaches to the lateral margin of the lateral tibial condyle and can look just like the anterosuperior tibiofibular ligament.

So how do you differentiate the two?

  1. When you scroll on the axial scans from superior to inferior, the Biceps Femoris tendon is seen first (Pink arrows).
  2. There is usually a gap between the tendon and ligament (like in the image).
  3. The next structure you will see is the Ligament ( Orange Arrows).
  4. So the first linear structure you see is the tendon ( pink arrows) and the more distal linear structure is the ligament (Orange arrow).
  5. Occasionally the two are fused and there will only be one linear structure.

 

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What’s the Purpose of the Tuesday Tips?: Many of the Tuesday Tip posts arise from questions or difficulties that people bring up in the Mini Fellowships. These posts are meant to be short and concise to answer those questions.

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