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Anterior colliculus of medial malleolus

The anterior colliculus of the medial malleolus is the smaller, anterior bony prominence on the medial malleolus of the tibia. It serves as an important attachment site for components of the deltoid ligament and contributes to the contour of the medial ankle mortise.

It is a key anatomical landmark in ankle anatomy, ligament evaluation, trauma assessment, and surgical planning.

Synonyms

  • Anterior tubercle of the medial malleolus

  • Anterior collicular process

Location

  • Situated on the anterior aspect of the medial malleolus

  • Anterior to the posterior colliculus

  • Superior to the apex of the medial malleolus

  • Medial to the talar body

  • Forms part of the medial wall of the ankle mortise

Anatomical components

  • Osseous prominence of the distal tibia

  • Cortical shell with underlying cancellous bone

  • Ligament attachment zone:

    • Superficial fibers of the deltoid ligament (especially tibionavicular and tibiospring components)

  • Articular relationship:

    • Does not articulate directly, but shapes the medial ankle contour

Relations

Anteriorly:

  • Anterior tibiotalar joint capsule

Posteriorly:

  • Intercollicular groove

  • Posterior colliculus of the medial malleolus

Medially:

  • Subcutaneous tissue and skin

Laterally:

  • Talar medial articular surface

Inferiorly:

  • Apex of the medial malleolus

Superiorly:

  • Distal tibial metaphysis

X-ray appearance

Plain radiographs (AP and mortise ankle views):

  • Anterior colliculus: Appears as a subtle bony projection on the anterior margin of the medial malleolus

  • Best visualized on: Mortise and oblique views

  • Cortical outline: Smooth and continuous

  • Relationship: Seen projecting slightly anterior to the main malleolar body

CT appearance

Non-contrast CT:

  • Anterior colliculus: Clearly defined anterior bony prominence of the medial malleolus

  • Cortical margins: Sharp and well-demarcated

  • Trabecular pattern: Normal cancellous bone texture

  • Spatial detail: Excellent for assessing morphology and small cortical irregularities

  • Relation to intercollicular groove: Well demonstrated

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Underlying marrow: High signal

  • Anterior colliculus contour: Well delineated against surrounding soft tissues

T2-weighted images:

  • Cortex: Low signal

  • Adjacent joint fluid: High signal outlining the colliculus

  • Deltoid ligament fibers: Low-to-intermediate signal structures attaching near this region

STIR:

  • Fat suppression: Uniform marrow fat suppression

  • Collicular margins: Clearly visualized

  • Capsular and ligamentous structures: High contrast against suppressed marrow

Proton density fat-saturated (PD FS):

  • Bone marrow: Fat signal suppressed

  • Joint fluid: High signal

  • Ligament attachments: Well seen as low-signal bands at the anterior colliculus

CT VRT 3D image

Anterior colliculus of medial malleolus 3d

MRI image

Anterior colliculus of medial malleolus mri anatomy labelled image-img-00000-00000