Objective. To describe the sonographic findings of lower extremity interosseous membrane disruption with computed tomographic and surgical correlation. Methods. Three patients with sonographic evaluation of the lower extremity interosseous membrane were identified through the clinical experience of 1 author over a 5-year period. Sonographic images of the symptomatic and unaffected lower extremities were retrospectively characterized and correlated with computed tomographic and surgical findings by 2 fellowship-trained musculoskeletal radiologists. Results. The normal interosseous membrane was identified in the asymptomatic lower extremities in all 3 patients, which appeared as a thin, hyperechoic (nearly equal to bone cortex) line, continuous from the tibia to the fibula. The abnormal interosseous membrane in all 3 cases appeared abnormally hypoechoic, poorly defined, and discontinuous at the tibia. A proximal fibular fracture was shown on sonography in 1 of 3 symptomatic lower extremities with radiographic evidence of a fracture. The sonographic findings correlated with the computed tomographic images. Distal tibiofibular syndesmosis injuries were confirmed and treated at surgery in 2 patients. Conclusions. Sonography can show both normal and injured interosseous membranes of the lower extremity, as well as associated proximal fibular fractures.
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