 Alright, so in the anterior quadrant, we assess the anterior recess of the tibiotiler joint, we assess the anterior inferior tibiofibular ligament, the anterior talofibular ligament, the calcaneofibular ligament, next tense attendance and the dorsal mid dorsal ligaments. Anterior recess of the tibiotiler joint is easily assessed by routine ultrasound techniques whereas the posterior joint recess may be a little bit difficult to assess unless the joint is really distended by a lot of fluid. The sub talo joint space may communicate with the tibiotiler joint space in approximately 10 percent of the patients. So we start scanning the anterior joint recess in the long axis by identifying the tibia, the talodome and the talonic and just above the talodome what we see is a hypoechoic cartilage of the talodome and just anterior to that you have an intraarticular but extraceinovial fat pad. So when we screen from medial to lateral we look for joint effusion in the long axis so this is the patient wherein on the left side this is the normal ankle joint where we see the tibia, the talus and the anterior fat pad whereas on the right side we see that the effusion has caused the anterior fat pad to be displaced anteriorly. Coming to the anterior inferior tibia fibula ligament, this ligament is actually a stendosmotic ligament which spans the tibia and the fibula. I would encourage you to look at the fibers you know the orientation of the fibers of the anterior inferior tibia fibula ligament so that when we want to scan the AITFL we identify the fibula and the tibia and we put our probe obliquely in the direction of the fibers hence we see the AITFL as an ecogenic structure with multiple linear striations. The anterior talofibula ligament is the most commonly injured ligament in inversion injuries of the ankle hence this is one of the most common indications for ultrasound assessment of the ankle joint to see the integrity of the AITFL. Now if we look over here on this gross anatomy dissection we see that the ligament spans the lateral malleolus and it goes all the way across to the talar neck and if you see the orientation of the ligament is almost parallel that to the plantar surface of the foot so we assess the AITFL by putting the plantar surface of the foot on the you know over the bed flat on the bed and we connect the two connect the two bony prominences this is the lateral malleolus and that's the talus and this is what we see over here that is the anterior talofibula ligament which is seen as a nice ecogenic structure multiple striations and you see a little bit of fluid in the lateral gutter this little triangular space is known as a lateral gutter which is a part of the anterior joint recess the calcaneofibula ligament is located between the calcaneum and the fibula the fibula attachment may be slightly difficult to assess however when you do a forced dorsiflexion you will be able to see the entire calcaneofibula ligament really well and during dorsiflexion you cause the ligament becomes taut and you see the peroneal tendons which over here they are seen much more better so this is a ligament which would require a little bit of dynamic maneuvering and this ligament can be easily assessed on the long axis coming to the extensor tendons the extensor tendons are typically your tibialis anterior your extensor halosus longus and your extensor digitorum longus tendons so the pathologies of extensor tendons are very few but you know they're commonly injured you know and they may get injured when there is a sharp injury and they may in my result in complete tearing of the tendon the extensor halosus longus is the most commonly torn tendon that we see from middle to lateral we see the tibialis anterior the extensor halosus longus the tibialis anterior artery the nerve and the extensor digitorum longus as the lateral most tendon the superior inferior extensor retinaculi are located at these levels and the tendon sheets are located at the levels of the inferior extensor retinaculi on the long axis the tibialis anterior the extensor halosus longus and the extensor digitorum longus are seen as a typical fibrillary pattern with a collagen bundles crossing through and disruption of these bundles should be suspected when there's a tear or tendinosis and coming to the dorsal and mid dorsal ligaments we are typically talking about the dorsal telonavicular the bifurcate ligament and the calcaneocuboid ligament now these ligaments can be easily injured in high-grade inversion injuries and this are commonly missed on you know routine imaging such as the radiographs hence when the patient comes for assessment of inversion injuries these ligaments should also be scanned to roll out any obvious ligament injury so this is how it looks on the gross appearance so this structure which has been labeled as 12 that is a the dorsal telonavicular ligament the structure which has been labeled over here just anterior to the anterior superior process of the calcaneum that's your bifurcate ligament and the structure the lateral most is a calcaneocuboid ligament so dorsal telonavicular ligament we connect the navicular and the talus and we see this nice ligament over here very superficial structure similar case with the bifurcate ligament we identify the anterior superior process of the calcaneum and the ligament is seen as a of a echogenic chord like structure and similar appearance for of the calcaneocuboid ligament by connecting the cuboid and the calcaneum