Misdiagnosis of the distal tibiofibular syndesmotic injury could lead to significant long-term morbidity.

Our results show that CT scan measurements of the distal tibiofibular joint are wider than and significantly different from that measured from MRI.

We therefore recommend that when the widening found on a CT scan is minor or the diagnosis is equivocal, a contralateral comparative CT or an ipsilateral MRI scan is obtained to prevent misdiagnosis.

To our knowledge, this is the first study to correlate CT and MRI findings of the distal tibiofibular joint.