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Ultrasound image of a normal ATFL (A) for comparison with the same region of the anterolateral ankle in our patient (B). The normal ATFL (arrows in image A) demonstrates a hyperechoic compact fibrillar pattern between its attachment to both the fibula (fib) and talus (tal). In our patient (image B), the ATFL is notably absent due to chronic tearing and has been replaced by disorganized, hypoechoic (dark) synovial tissue (asterisks).
