Objective: Surgical repair of the spring ligament is becoming recognized as an important management component of adult-acquired flatfoot, yet little literature exists on the MRI appearance of spring ligament abnormalities. In this article, we describe the MRI appearance of surgically proven spring ligament tears.
Conclusion: MRI findings present in surgically proven spring ligament tears include an abnormal spring ligament caliber, signal intensity, waviness, a full-thickness gap, and posterior tibial tendonopathy. The finding unique to cases with surgically proven tears is a full-thickness gap in the ligament, seen in 79% of the cases in our series. When multiple abnormalities are seen in the spring ligament in conjunction with a full-thickness gap, the diagnosis of a tear can be made with confidence.