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Fibular notch of tibia

The fibular notch of the tibia (also called the peroneal notch or incisura fibularis) is a concave groove on the lateral aspect of the distal tibia that articulates with the distal fibula. It forms the tibial component of the distal tibiofibular syndesmosis and plays a crucial role in ankle stability and load transmission.

It is an important anatomical landmark in ankle anatomy, trauma assessment, and cross-sectional imaging.

Synonyms

  • Incisura fibularis

  • Peroneal notch of the tibia

Location

  • Located on the lateral surface of the distal tibia

  • Immediately proximal to the tibial plafond

  • Faces laterally toward the distal fibula

  • Forms the tibial side of the distal tibiofibular joint

  • Superior to the lateral malleolus

Anatomical components

  • Concave articular surface of the tibia

  • Anterior tubercle:

    • Attachment for anterior inferior tibiofibular ligament (AITFL)

  • Posterior tubercle:

    • Attachment for posterior inferior tibiofibular ligament (PITFL)

  • Articular cartilage lining for fibular articulation

  • Syndesmotic ligaments:

    • Interosseous tibiofibular ligament

    • AITFL and PITFL

Relations

Laterally:

  • Distal fibula (lateral malleolus)

Medially:

  • Tibial metaphysis and medullary cavity

Anteriorly:

  • Anterior inferior tibiofibular ligament

  • Ankle joint capsule (anterolateral aspect)

Posteriorly:

  • Posterior inferior tibiofibular ligament

Inferiorly:

  • Tibial plafond and ankle joint surface

Superiorly:

  • Distal tibial metaphysis

X-ray appearance

Ankle radiographs (AP, mortise views):

  • Fibular notch: Appears as a shallow concavity along the lateral distal tibia

  • Distal fibula: Normally seated within the notch

  • Syndesmotic alignment: Evaluated by tibiofibular clear space and overlap

  • Margins: Smooth cortical outlines

CT appearance (Pre-contrast)

Non-contrast CT:

  • Fibular notch: Clearly defined concave bony groove

  • Cortical margins: Smooth and sharply outlined

  • Articular surface: Well visualized cartilage-bone interface

  • Syndesmosis: Accurate assessment of fibular position within the notch

  • Spatial evaluation: Ideal for subtle malalignment or anatomical variation

MRI appearance

T1-weighted images:

  • Cortical bone: Low signal intensity

  • Marrow of distal tibia: High signal intensity

  • Fibular notch surface: Smooth low-signal contour

  • Fibula: Well aligned against the notch

T2-weighted images:

  • Articular cartilage: Intermediate signal lining the notch

  • Joint fluid: High signal outlining the distal tibiofibular joint

  • Ligaments: Low-signal bands adjacent to the notch

STIR:

  • Bone marrow: Uniform fat suppression

  • Articular margins: Well delineated

  • Distal tibiofibular space: Clearly visualized

Proton density fat-saturated (PD FS):

  • Cartilage and joint fluid: High signal

  • Ligaments: Low-signal linear structures

CT VRT 3D image

Fibular notch of tibia 3d

MRI image

Fibular notch of tibia mri anatomy labelled image-img-00000-00000

CT image

Fibular notch of tibia axial ct