The MRI demonstrates grade 2 AITFL and grade 2 PITFL injuries, although these could be healing grade 3 injuries, especially the AITFL injury, given the timeframe (8 weeks) from injury. The posterior malleoli edema is suspicious for a PITFL avulsion injury. The distal tibiofibular syndesmosis is widened (best seen on the x-ray) and mildly hyperintense on the MRI.
Disclosure: I, Henry Knipe, have no actual or potential ethical or financial conflict of interest in relation to the TightRopeTM device. This case is not intended to be a personal endorsement or recommendation of this product.