Image Above: Synovitis and scarring in the gutter usually caused by tears to the  ATFL and AiTFL. When the talus dorsiflexes, it can impinge on the scar or synovitis with pain and or loss of range of movement.

Image Above: The normal anterolateral gutter should just have fluid ( see initial image in post). Synovitis ( blue arrows) in the gutter seen as linear areas of decreased signal. However its important to word the report appropriately as not everyone with synovitis has impingement. Describe your findings and say it may lead to impingement but dont say its causing impingement.

Image Above: Torn and scarred AiTFL ( blue arrows) with scar filling the anterolateral gutter.

Image Above: Torn ATFL ( pink arrows) with scar extending up into the antero lateral gutter ( blue arrows)

Image Above: Normal Capsule ( blue arrows) between the AiTFL ( yellow arrow) and the ATFL ( ( pink arrow) and anterolateral recess ( green arrows). Normal capsule is thin and well defined. In this patient minor synovitis deep to the capsule.

Image Above: Thick and torn/ scarred anterior capsule ( blue arrows).